Aman Qari Muhammad Younas, Rasul Maaz, Khan Amna, Ali Basit, Faheem Muhammad, Balouch Aiman, Khattak Imran Qadar
Medicine and Surgery, Lady Reading Hospital, Peshawar, PAK.
Medicine and Surgery, Gomal Medical College, DI Khan, PAK.
Cureus. 2025 Apr 24;17(4):e82944. doi: 10.7759/cureus.82944. eCollection 2025 Apr.
Dengue fever and enteric fever, two prevalent infectious diseases in tropical and subtropical regions, pose significant public health challenges due to their overlapping clinical manifestations and distinct therapeutic approaches. This study aims to evaluate hospitalization and management protocols for both illnesses, assessing their adherence to clinical guidelines and examining patient outcomes across diverse healthcare settings.
A retrospective cross-sectional study was conducted by reviewing hospital records over a five-year period (April 2019-April 2024). A total of 218 individuals diagnosed with enteric fever (n=98) and dengue fever (n=120) were included in the study. Data were retrospectively collected using standardized forms from hospital records, laboratory reports, and discharge summaries to capture demographics, clinical presentations, lab findings, treatments, complications, and outcomes for patients with dengue or enteric fever. Statistical analysis was conducted using SPSS, Version 26 (IBM Corp., Armonk, NY), applying descriptive statistics, chi-square test, t-test, logistic regression, and Cox modeling to evaluate associations between treatment protocols and patient outcomes, with significance set at p<0.05.
Dengue and enteric fever showed distinct clinical patterns: rash and headache were more common in dengue fever, while abdominal pain and diarrhea predominated in enteric fever. Although demographic differences in age, sex, and residence were observed, they were not statistically significant. Improved outcomes in dengue fever were significantly associated with fluid replacement (n=110, 91.67%, p=0.02), reflecting the collective effect of standard supportive care measures. In contrast, antibiotic therapy (n=98, 100.00%, p=0.01) was central to favorable outcomes in enteric fever. Dengue fever was primarily diagnosed through serological testing (n=115, 95.83%), while enteric fever relied on blood cultures (n=78, 79.59%) (χ²=126.98, p<0.0001, OR=0.02). Hospitalization durations were significantly longer in enteric fever, patients staying ≥5 days compared to dengue fever patients (χ²=8.76, p=0.0031, OR=0.39). Recovery without complications was slightly more frequent in dengue fever (n=112, 93.33%) than in enteric fever (n=88, 89.80%), though this difference was not statistically significant (χ²=0.49, p=0.483, OR=0.60). These findings apply to general dengue fever cases only; patients with dengue hemorrhagic fever were managed separately due to differing clinical protocols.
This study highlights the necessity of tailored treatment protocols for enteric and dengue fever, emphasizing the importance of strict adherence to established clinical guidelines to optimize patient outcomes, particularly in resource-limited healthcare settings. While appropriate management, such as antibiotic therapy for enteric fever and supportive care for dengue, is well defined, differentiating between these conditions based solely on clinical presentation remains a significant challenge due to overlapping symptoms with other febrile illnesses. This diagnostic ambiguity underscores the urgent need for more robust, accessible, and rapid diagnostic tools. Furthermore, ongoing education and capacity building for healthcare professionals are essential to enhance clinical judgment, ensure early recognition, and improve compliance with evolving evidence-based practices in the management of febrile illnesses.
登革热和伤寒是热带和亚热带地区两种常见的传染病，由于其临床表现重叠且治疗方法不同，对公共卫生构成了重大挑战。本研究旨在评估这两种疾病的住院治疗和管理方案，评估其对临床指南的遵循情况，并检查不同医疗环境下的患者结局。
通过回顾五年期间（2019年4月至2024年4月）的医院记录进行了一项回顾性横断面研究。共有218例被诊断为伤寒（n = 98）和登革热（n = 120）的患者纳入研究。使用标准化表格从医院记录、实验室报告和出院小结中回顾性收集数据，以获取登革热或伤寒患者的人口统计学信息、临床表现、实验室检查结果、治疗、并发症和结局。使用SPSS 26版（IBM公司，纽约州阿蒙克）进行统计分析，应用描述性统计、卡方检验、t检验、逻辑回归和Cox模型来评估治疗方案与患者结局之间的关联，显著性设定为p<0.05。
登革热和伤寒表现出不同的临床模式：皮疹和头痛在登革热中更常见，而腹痛和腹泻在伤寒中占主导。虽然在年龄、性别和居住地方面观察到人口统计学差异，但无统计学意义。登革热患者结局的改善与液体补充显著相关（n = 110，91.67%，p = 0.02），反映了标准支持性护理措施的综合效果。相比之下，抗生素治疗（n = 98，100.00%，p = 0.01）是伤寒患者良好结局的关键。登革热主要通过血清学检测确诊（n = 115，95.83%），而伤寒则依赖血培养（n = 78，79.59%）（χ² = 126.98，p<0.0001，OR = 0.02）。伤寒患者的住院时间明显更长，与登革热患者相比，住院≥5天的患者更多（χ² = 8.76，p = 0.0031，OR = 0.39）。登革热患者无并发症康复的频率略高于伤寒患者（n = 112，93.33% 对比 n = 88，89.80%），尽管这种差异无统计学意义（χ² = 0.49，p = 0.483，OR = 0.60）。这些发现仅适用于一般登革热病例；登革出血热患者因临床方案不同而单独管理。
本研究强调了针对伤寒和登革热制定个性化治疗方案的必要性，强调严格遵循既定临床指南以优化患者结局的重要性，特别是在资源有限的医疗环境中。虽然诸如伤寒的抗生素治疗和登革热的支持性护理等适当管理已明确，但由于与其他发热性疾病症状重叠，仅根据临床表现区分这些疾病仍然是一项重大挑战。这种诊断的模糊性凸显了对更强大、可及且快速的诊断工具的迫切需求。此外，持续对医疗专业人员进行教育和能力建设对于提高临床判断力、确保早期识别以及改善对发热性疾病管理中不断发展的循证实践的依从性至关重要。
