Asim Khurshid, Junaid Rashid.
Clinical presentation of typhoid fever.
Ann King Edward Med Uni Jan ;12(4):556-9.

Introduction: Enteric fever represents a spectrum of acute systemic febrile illness with a myriad of presentations and complications. Aims: This study was carried out to evaluate the demographic data such as age, sex, clinical features and outcome of enteric fever patients presenting in District headquarter hospital Muzuffar Garh. Material and methods: Over a period of one year all children presenting with clinical and/or laboratory diagnosis of Typhoid fever, who were admitted to the Social Security Hospital M. Garh, were evaluated. The diagnosis of enteric fever was based on a positive Salmonella typhi or paratyphi blood/stool culture and/or a Widal serodiagnosis > or =1/160 for 0 agglutinin, in the presence of evocative symptoms. Results: There were 28(66.66%) male and 14(33.33%) female patients, ranging from 1 to 12 years, with a mean age of 6 years. Predominant symptoms were fever, prostration and apathy; anorexia and abdominal pain while the predominant signs were fever, coated tongue, toxic look, hepatosplenomegaly and abdominal tendemess. Hepatomegaly was observed almost as frequently as splenomegaly. Common clinical signs of typhoid fever in adults such as relative bradycardia and rose spots were seldom documented. All patients survived from their severe illness completely. Conclusions: Although there is considerable diversity in the clinical spectrum of typhoid fever, yet a presumptive clinical diagnosis of typhoid fever may be made with a combination of clinical features so that appropriate therapy may be started at the earliest possible time to avoid the increasing drug resistance, morbidity and mortality with typhoid fever.

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