Liaquat Ali, Azmat Talat, Faiz M Khan, Irshad Ahmad, Javaid Pervez, Liquat Ali Khan.
Multi drug resistant typhoid fever.
Pak Paed J Jan ;19(2):49-54.

Typhoid fever has always been prevalent in this pan of die world. Recent years have witnessed a dramatic change in the clinical pattern and therapeutic response of this disease. One hundred consecutive cases of typhoid fever were prospectively studied in Pediatric B ward PGM1/LRH, over a period of one year, from March, 1993 to February, 1994. Male to female ratio was 2:1. Age ranged from 1 to 14 years (average 6.35 yrs). Fever was present in 100% cases. Diarrhoea (40%) hepatomegaly (27%) and splenomegaly (13%) were important GA. manifestations. Patients of younger age and those with visceromegaly were generally more toxic. Prehospitalization antibiotics were used by 90% of the patients. Besides routine investigations widal and bone marrow c/s were performed in all cases. Blood c/s was done in 50 cases. Widal test was positive in 56% cases. Bone marrow c/s yield was 60% while blood c/s was positive in only 16% of cases. The in vitro resistance figures for amoxycillin, chloramplrenicol and cotrimoxazole were 81.7%, 83.3% and 95% respectively. Multi drug resistance was found in 18.3% isolates. Sensitivity was observed to ofloxacin (100%), ciprofloxacin (98.33%), cefotaxime (88.3%) and ceftriaxone (86.6%) respectively. Average hospitalization duration was 8.4 days and mean defervesence time was 5.4 days. No mortality was recorded. We conclude that Widal test continues to be an easy and cheap screening test. Bone marrow c/s is die investigation of choice for definitive diagnosis of enteric fever. Resistance to die newer antibiotics may be on the rise.

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