Green S D, Cheesbrough J S
Institut Médical Evangélique, Kimpese, Bas-Zaïre.
Ann Trop Paediatr. 1993;13(1):45-53. doi: 10.1080/02724936.1993.11747624.
An analysis of 206 cases of extra-intestinal Salmonella infection among children up to 60 months of age admitted to a rural hospital in western Zaire was undertaken. Most children presented with fever but without any focus of infection which was difficult to distinguish clinically from falciparum malaria. The majority (83%) of the infections were due to serotypes other than S. typhi. Infection with these serotypes was clinically indistinguishable from S. Typhi infection and was associated with a comparably high case fatality rate of 23%. Death was significantly associated with age under 6 months (relative risk 1.7), meningitis (RR 4.7), jaundice (RR 2.5), severe anaemia (RR 1.8), contracting disease in the late wet season when malnutrition peaks (RR 2.6) and infection with a chloramphenicol-resistant isolate (RR 3.2). The increasing prevalence of antibiotic resistance and HIV infection will complicate the management of this disease in the future.
对扎伊尔西部一家乡村医院收治的206例60个月以下儿童肠外沙门氏菌感染病例进行了分析。大多数儿童表现为发热，但无任何感染病灶，临床上难以与恶性疟区分开来。大多数（83%）感染是由伤寒沙门氏菌以外的血清型引起的。这些血清型感染在临床上与伤寒沙门氏菌感染无法区分，且病死率相当高，为23%。死亡与以下因素显著相关：6个月以下年龄（相对风险1.7）、脑膜炎（RR 4.7）、黄疸（RR 2.5）、严重贫血（RR 1.8）、在营养不良高峰期的雨季后期患病（RR 2.6）以及感染耐氯霉素菌株（RR 3.2）。抗生素耐药性和艾滋病毒感染患病率的不断上升将使未来这种疾病的管理变得更加复杂。
