scholarly journals Bone Marrow Granuloma in Typhoid Fever: A Morphological Approach and Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Kavitha Muniraj ◽  
Somanath Padhi ◽  
Manjiri Phansalkar ◽  
Periyasami Sivakumar ◽  
Renu G’Boy Varghese ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Typhoid Fever ◽  
Bacterial Infections ◽  
Bone Marrow Examination ◽  
Salmonella Typhi ◽  
Suspected Case ◽  
Morphological Aspect ◽  
Morphological Marker ◽  
Prolonged Fever ◽  
Bone Marrow Granuloma

Typhoid fever is one of the few bacterial infections in humans where bone marrow evaluation is routinely recommended. However, the morphological aspect of typhoid fever in bone marrow has been rarely described in the literature. We describe a 25-year-old male patient who presented with prolonged fever suspected to be of tubercular etiology. Bone marrow examination showed well-formed histiocytic and epithelioid granulomas and erythrophagocytosis; and the bone marrow aspirate culture grewSalmonella typhiA. In view of potential clinical implications, typhoid fever should be considered as a differential diagnosis to tuberculosis in the evaluation of prolonged fever; especially in high prevalent areas. We suggest that erythrophagocytosis may serve as a morphological marker in typhoid granulomas in the bone marrow; and bone marrow culture should be submitted in every suspected case for appropriate patient management.

scholarly journals Acute sensorineural hearing loss as atypical presentation of typhoid fever in adult patient

2020 ◽  
Vol 8 ◽  
pp. 2050313X2095854
Author(s):  
Khaled Al Khodari ◽  
Tehniyat Baig ◽  
Mohammad Husni Alkhateeb ◽  
Muhammad Naeem
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Typhoid Fever ◽  
Bacterial Infections ◽  
Salmonella Typhi ◽  
Acute Onset ◽  
Atypical Presentation ◽  
Diagnostic Challenge ◽  
Intravenous Antibiotics ◽  
Neurological System

Salmonella Typhi is the main cause of an acute febrile, sometimes fatal, multisystemic illness called typhoid fever. The diverse presentations of this disease make it a diagnostic challenge in some patients. Involvement of the neurological system, including cochleovestibular system, is very rare with less than a handful of reported cases. This case report describes the condition of a previously healthy 23-year-old Pakistani man with acute onset of hearing loss associated with fever, headache, and disorientation. The most likely differential diagnoses were bacterial or viral meningoencephalitis, and other bacterial infections, such as Rickettsial and spirochetal diseases. Salmonella Typhi grew on blood culture; thus, treatment with intravenous antibiotics and systemic steroids was provided with excellent response. Hearing loss gradually improved and almost completely resolved within 3 to 4 weeks.

Role of bone marrow examination in the child with prolonged fever

1990 ◽  
Vol 116 (6) ◽  
pp. 919-920 ◽  
Author(s):  
Ammar Hayani ◽  
Donald H. Mahoney ◽  
Donald J. Fernbach
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Examination ◽  
Prolonged Fever

scholarly journals Outbreak of domestically acquired typhoid fever in Leipzig, Germany, June 2004

2007 ◽  
Vol 12 (2) ◽  
pp. 7-8 ◽  
Author(s):  
M Muehlen ◽  
C Frank ◽  
W Rabsch ◽  
A Fruth ◽  
M Suckau ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Salmonella Typhi ◽  
Suspected Case ◽  
Positive Serology ◽  
Probable Case ◽  
Source Of Infection ◽  
Health Authorities ◽  
Unexplained Fever ◽  
History Of ◽  
A Site

In June 2004, three confirmed cases of typhoid fever were reported to the health authorities in Leipzig, Germany. The patients had been admitted to hospital with unexplained fever and otherwise mild symptoms. All were members of the same pony club, none had been abroad. A retrospective cohort study among pony club members was performed to identify the source of infection. A suspected case was defined as unexplained fever >=38.5°C over three or more days since 1 May 2004. Additional positive serology defined a probable case and Salmonella Typhi isolation from blood or stool cultures a confirmed case. All hospitals, paediatricians and general practitioners in Leipzig and surroundings were contacted to identify additional cases. In total, six cases were identified, all among pony club members: four confirmed, including the three originally reported cases, one probable and one suspected. The only exposure common to all cases during the probable time of infection was consumption of sandwiches with herb dressing from a snack bar on 25 or 26 May (May 25: RR=5.7; 95% CI 0.9-37.9; both days: RR=, P=0.007). Foods and workers from the snack bar tested negative. However, one worker, not previously registered with the health authorities, was identified during a site visit. It cannot be excluded that further unregistered individuals worked at the snack bar between May and June 2004. Despite intense case-finding activities, no further cases were identified among the population. The most likely vehicle in this outbreak was sandwiches with herb dressing, though the source of contamination remains unknown. Even without history of travel to endemic countries, physicians should consider typhoid fever when managing patients with unexplained fever.

Diagnostic utility of bone marrow examination in evaluation of fever: a descriptive study on 98 immunocompetent adults from a tertiary care institute in south India

2019 ◽  
Vol 49 (2) ◽  
pp. 88-96
Author(s):  
Sri Krishna Sai ◽  
Somanath Padhi ◽  
Renu G Boy Varghese ◽  
Reba Kanungo ◽  
Aneesh Basheer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Bone Marrow Examination ◽  
Salmonella Typhi ◽  
Bone Marrow Histology ◽  
Microbiological Characteristics ◽  
High Concordance ◽  
The Common ◽  
Immunocompetent Adults

Five-year clinico-laboratory data from 99 (one HIV seropositive) adults (mean age = 41.3 ± 20.4 years) who underwent bone marrow examination for fever persisting for ≥ 1 week were analysed and correlated with microbiological characteristics. Infections, reactive marrow changes and haematolymphoid malignancies were most commonly associated with fever. A high concordance rate of 71% was noted between aspiration and trephine biopsies. Bone marrow granulomas (BMG) were seen exclusively on sections and were most commonly of tubercular and typhoidal in origin (two Salmonella Typhi, one Salmonella Paratyphi A). The common aetiologies associated with fever and cytopenia(s) were BMG, acute leukaemia and haemophagocytic lymphohistiocytosis (HLH; n = 3). The yield from bone marrow culture was inferior compared to other body fluids. In conclusion, bone marrow histology is superior to smears in the evaluation of prolonged fever. Marrow culture may not be useful in immunocompetent individuals other than if Salmonellosis is suspected.

scholarly journals Different Diagnostic Procedure of Typhoid Fever: A Review Update

2014 ◽  
Vol 1 (2) ◽  
pp. 35-41 ◽  
Author(s):  
AFM Arshedi Sattar ◽  
M Abdullah Yusuf ◽  
M Bodrul Islam ◽  
Waseka Akhter Jahan
Keyword(s):  
Bone Marrow ◽  
Typhoid Fever ◽  
Diagnostic Procedure ◽  
Early Stage ◽  
Salmonella Typhi ◽  
Widal Test ◽  
Bacterial Isolation ◽  
Source Of Infection ◽  
Alternative Approach ◽  
Higher Sensitivity

Typhoid fever is diagnosed by using a combination of the clinical presentation, the isolation of Salmonella typhi from body fluids and by Widal test. In the first week of illness, the diagnosis may be more difficult because in this invasive stage with bacteraemia; the symptoms are those of generalized infections without localizing feature. Cultures of stool, urine, rose spots, bone marrow, gastric and intestinal secretions can all be useful for diagnosis. The efficacy of culture varies with the specimen being tested. In addition, the prehospital antibiotic therapy frequently used in developing countries complicates the isolation of infectious agents from clinical specimens especially from blood. Bone marrow appears to be the most suitable specimen because bone marrow culture has a higher sensitivity than blood culture. The methods of bacterial isolation are inherently slow and take more than 48 hours. That is why, serologic analysis becomes more important. The Widal test has got limitations such as the difficulty in interpretation, the need to demonstrate a fourfold rise after a week and necessity of knowing the endemicity of the area and is useful only in selected patients. The available methods of diagnosis of typhoid fever are either time consuming or are not absolutely reliable. An accurate diagnosis of typhoid at an early stage is important not only for an etiological diagnosis of the patient but also to identify individuals who may serve as a source of infection. The outer membrane protein on the surface of Gram negative bacteria has been considered as important antigens to induce host immune response. Enzyme-linked immunosorbent assays (ELISA) have been considered an alternative approach for the diagnosis of typhoid fever. Therefore, this present review has been designed to describe the different diagnostic procedure of typhoid fever.DOI: http://dx.doi.org/10.3329/jcamr.v1i2.20517 Journal of Current and Advance Medical Research Vol.1(2) 2014: 35-41

scholarly journals Results of Salmonella typhi culture in patients with suspected typhoid fever, treated in the Department of Child Health Medical School, Padjadjaran University, Hasan Sadikin General Hospital Bandung

1989 ◽  
Vol 29 (5-6) ◽  
pp. 105-11
Author(s):  
Nanan Sekarwana ◽  
Herry Garna ◽  
Azhali M. S.
Keyword(s):  
Bone Marrow ◽  
Child Health ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Medical School ◽  
General Hospital ◽  
Salmonella Typhi ◽  
The Third ◽  
Significant Difference ◽  
Vaccination History

From October to December 1984, examination has been carried out on Salmonella typhi cultures from blood, bone marrow, faeces and urine of 43 patients suffering from suspected typhoid fever treated in the Department of Child Health, Medical Schooll Hasan Sadikin General Hospital, Bandung.It was apparent that among these 43 patients, 51.2% were males and 48.8% females. The greater number of them were more than 5 years old (64.4%). The results of Salmonella typhi cultures were obtained  from 65% of the patients, consisting of 65% positive cultures from bone-marrow and 40% positive cultures from blood that showed a statistically significant difference (p < 0.05).Likewise, the time for matter-sampling for the examinations was based on the culture results, both on blood-culture and that of bone-marrow, statistically a significant was found (p < 0.05), whereas the results of cultures based on previous vaccination history and the administration of chloramphenicol prior to treatment did not differ significantly.It was obviously clear that the results of bone-marrow culture were more successful compared to those from blood culture, so that it should necessarily be emphasized, as to these examinations on culture from each patient with suspected typhoid fever, especially those patients hospitalized during the third week of their illness.

RELATIVE EFFICACY OF BLOOD, URINE, RECTAL SWAB, BONE-MARROW, AND ROSE-SPOT CULTURES FOR RECOVERY OF SALMONELLA TYPHI IN TYPHOID FEVER

The Lancet ◽  
1975 ◽  
Vol 305 (7918) ◽  
pp. 1211-1213 ◽  
Author(s):  
RobertH. Gilman ◽  
Miguel Terminel ◽  
MyronM. Levine ◽  
Pablo Hernandez-Mendoza ◽  
RichardB. Hornick
Keyword(s):  
Bone Marrow ◽  
Typhoid Fever ◽  
Rectal Swab ◽  
Salmonella Typhi ◽  
Relative Efficacy

Fundamentals of Bone Marrow Examination

1994 ◽  
Vol 8 (4) ◽  
pp. 651-663 ◽  
Author(s):  
Bong H. Hyun ◽  
Alan J. Stevenson ◽  
Cheryl A. Hanau
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Examination

Pancytopenia: A Challenging Problem for Treating Physician

2018 ◽  
Vol 2 (01) ◽  
pp. 22-28
Author(s):  
Md. Rezaul Karim Chowdhury ◽  
Amina Begum ◽  
Md. Haroon Ur Rashid ◽  
Md. Kamrul Hasan
Keyword(s):  
Bone Marrow ◽  
Physical Examination ◽  
Blood Smear ◽  
Peripheral Blood Smear ◽  
Bone Marrow Examination ◽  
Challenging Problem ◽  
Trephine Biopsy ◽  
Life Threatening ◽  
Underlying Pathology ◽  
Careful History

Pancytopenia is an important clinico-haematological entity and striking feature of many serious and life-threatening illnesses. Many haematological and non-haematological diseases involve the bone marrow primarily or secondarily and cause pancytopenia. Decrease in haemopoietic cell production, ineffective haemopoiesis and peripheral sequestration or destruction of the cells are the main pathophysiology of pancytopenia. The cause of pancytopenia thus may be lying in the bone marrow or in the periphery or both. Careful history, physical examination, simple blood work, review of the peripheral blood smear, sometimes bone marrow examination and trephine biopsy are required for diagnosis. Treatment and prognosis depend on the severity of pancytopenia and underlying pathology.

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