Sobia Ashfaq, Faryad Hussain, Samreen Ashraf, Shadab Masood, Asif Manzoor Basra, Farah Latif.
Diagnostic Value of Detection of Mesenteric Lymphadenopathy in the Early Diagnosis of Enteric Fever in a Resource Limited Setting.
Pak Paed J Jan ;46(3):235-41.

Objective: To determine the diagnostic value of detection of mesenteric lymphadenopathy (MLNs) in the early diagnosis of enteric fever in a resource limited setting. Study Design: Prospective cross-sectional study. Place and Duration of Study: It was conducted at the Department of Pediatrics, Government Teaching Hospital, Shahdara, Lahore from October 2020 to October 2021 Material and Methods: 286 patients fulfilling the operational definition of suspected/confirmed enteric fever between 6 months to 5 years of age were initially enrolled. Blood culture and USG abdomen were performed in all cases. Only culture confirmed cases (156/286) were included in the study. Data was analyzed using SPSS version 23. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MLNs to diagnose enteric fever were calculated. While logistic regression model was used to see the significant predictors of positive blood culture Results: MLNs were detected in 67.3% (n=105/156) patients, significantly more common in 1-5 year age group (P value 0.009). Diagnostic accuracy of MLNs to diagnose enteric fever was 65.88% with sensitivity and specificity of 67.31% and 61.82% respectively. While PPV and NPV were 83.33% and 40% respectively. Positive MLNs were highly predictive of positive blood culture (Odds ratio=5.837, CI-95%:2.12-15.99) as was fever (Odds Ratio=0.003, CI-95%:0.00-0.02) and hepatomegaly (Odds ratio=0.119, CI-95%: 0.03-0.40) Conclusion: Mesenteric lymphadenopathy can be used to diagnose enteric fever early in the course of illness in resource limited settings where enteric fever is endemic and blood culture is not available or could not be done.

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