Nasrallah S M, Nassar V H
Am J Gastroenterol. 1978 Jan;69(1):63-9.
The records of 104 patients with culture-proven enteric fever were reviewed and evaluated as to the clinical signs, laboratory findings, pathologic features and complications of the disease. One patient with fatal disseminated intravascular coagulation and enteric fever is also presented. Fever and bradycardia were the leading clinical signs followed by splenomegaly, hepatomegaly and rose spots. The principal complications of enteric fever included anemia, typhoid hepatitis, relapse and bleeding. Evidence of typhoid hepatitis was present in 30% of the patients tested. The pathology consisted of typhoid nodules of variable frequency and size depending upon the severity of the condition. The relationship of typhoid hepatitis to relapse seems to be more than coincidental as four out of seven patients who had relapse had abnormal liver tests. The occurrence of disseminated intravascular coagulation in enteric fever is rare; however, awareness of such a potential complication may be life-saving to the patient.
回顾并评估了104例经培养证实为肠热症患者的记录,内容涉及该疾病的临床体征、实验室检查结果、病理特征及并发症。还介绍了1例死于播散性血管内凝血合并肠热症的患者。发热和心动过缓是主要临床体征,其次是脾肿大、肝肿大和玫瑰疹。肠热症的主要并发症包括贫血、伤寒性肝炎、复发和出血。30%接受检测的患者有伤寒性肝炎的证据。病理表现为伤寒结节,其频率和大小因病情严重程度而异。伤寒性肝炎与复发之间的关系似乎并非偶然,因为7例复发患者中有4例肝功能检查异常。肠热症患者发生播散性血管内凝血的情况罕见;然而,认识到这种潜在并发症可能会挽救患者生命。