Waqar Hussain, Aslam M, Aniqa Haider, Ghazala Jaffery, Akbar Malik.
Clinical spectrum of Typhoid Fever in children a descriptive study at Shaikh Zayed Hospital, Lahore.
Pak Paed J Jan ;26(2):71-5.

Objective: Enteric fever is an important public health problem in the developing world. Definitive diagnosis of typhoid requires certain laboratory investigations, but a single test may not have sufficient sensitivity to make a confident and rapid diagnosis in endemic areas. Emphasis must be given to clinical diagnosis of typhoid fever especially in communities where laboratory services are not available, so that a rapid diagnosis can be made and appropriate treatment started on clinical grounds without waiting for pending laboratory investigations. Therefore it is important to study the common clinical spectrum of typhoid fever that favours its diagnosis. Methods: A descriptive study was carried out in 75 patients from July 2000 to July 2001 admitted with suspected typhoid fever. These patients were either , Widal, or blood culture positive. Results: Out of 75 patients admitted with the diagnosis of typhoid fever, 47 (62.6%) were male and 28 (37.3%) were female patients. Maximum incidence was seen in 5-15 years age group (73%). Forty (53%) patients had duration of fever of 7-14 days. It was worth noting that fever was the most consistent feature in all patients. Fever was mostly high grade (67%) and remittent (73%). In most of the patients, there was history of gastrointestinal complaints like loose motions, vomiting, pain abdomen, followed by respiratory complaints. Coated tongue and hepatomegaly were important physical findings especially in toxic patients. Conclusions: Although the clinical features of typhoid fever are not distinctive and there is considerable diversity in its clinical spectrum, yet it may be possible to make a presumptive clinical diagnosis of typhoid fever with a combination of clinical features so that a rapid diagnosis may be made and appropriate therapy started to avoid the increasing drug resistance and mortality due to typhoid fever.

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