scholarly journals Clinical Profile of Enteric Fever in Children of a Tertiary Care Centre in Kathmandu, Nepal

2020 ◽  
Vol 3 (2) ◽  
pp. 122-127
Author(s):  
Sunil Budhathoki ◽  
Satyam Rimal ◽  
Lopsang Lama ◽  
Sabina Shrestha ◽  
Seshananda Sanjel ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Typhoid Fever ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
College Teaching ◽  
Common Finding ◽  
Female Ratio ◽  
Laboratory Parameters ◽  
Common Features ◽  
Loose Motion

Background: Enteric fever, commonly known as typhoid fever is a global public health problem. It is one of the common infectious diseases of humans, fever lasting for more than 7 days. It is transmitted by faecooral route and common in the areas with poor sanitation. Globally, majority of the Typhoid fever is caused by Salmonella enterica var typhi, one fifth of the infection is caused by Salmonella enterica var paratyphi. This study was conducted to describe clinical and laboratory parameters among children with enteric fever. Methods: It was a descriptive cross-sectional study conducted in the Pediatric ward and Pediatric Intensive Care Unit (PICU) of Nepal Medical College Teaching Hospital (NMCTH), Atterkhel, Kathmandu, Nepal from 2015 January to 2015 December. Inclusion criteria: clinical details and laboratory parameters of children aged 13 months to 15 years old with diagnosis of enteric fever was obtained in the proforma and descriptive statistics were calculated. Result: A total of 1,020 children with the sign and symptom suggestive of enteric fever were admitted in the inpatient department (Pediatrics) during the study period. All the enteric fever suspected children were tested for blood culture, Widal test and complete blood count, out of them 80 children were diagnosed as enteric fever. Male female ratio is 1.6:1. Fever was the most common clinical feature observed in 95% cases and other common features were loose motion (37.5%), vomiting (33.8%) and abdominal pain (27.5%). Hepato-splenomegaly is common finding of Enteric fever reported in 85.0% and 43.7%. Majority of the patients had normal leucocyte count (71.0%) and leucopenia reported in 20.0%. Conclusion: Fever and hepato-splenomegaly were the major clinical presentation of typhoid fever in our study. Other less common features were loose motion, vomiting and abdominal pain. This finding may be useful for the pediatrician and other health professionals for the early diagnosis of enteric fever.  

scholarly journals Mysterious Looks of Typhoid Fever: A New Experience

2015 ◽  
Vol 3 (1) ◽  
pp. 36-38 ◽  
Author(s):  
Deepankar Kumar Basak ◽  
Richmond Ronald Gomes ◽  
Md Ashraf Uddin Ahmed ◽  
ABM Sarwar E Alam
Keyword(s):  
Acute Pancreatitis ◽  
Pulmonary Hypertension ◽  
Abdominal Pain ◽  
Typhoid Fever ◽  
Enteric Fever ◽  
Wide Spectrum ◽  
Case Reports ◽  
Salmonella Typhi ◽  
Shortness Of Breath ◽  
Common Infectious Disease

Enteric fever (typhoid or paratyphoid) is a common infectious disease worldwide, especially in developing countries like Bangladesh. Typhoid fever caused by the gram negative bacterium Salmonella typhi that may have a wide spectrum of clinical presentations. We report a case of a 17 year old previously healthy college boy who presented with fever, abdominal pain and shortness of breath later on who was eventually diagnosed as having typhoid fever complicated by acute pancreatitis, hepatitis and severe pulmonary hypertension. Enteric fever presenting as acute pancreatitis and pulmonary hypertension is a rare entity and must be considered in endemic areas like Bangladesh, in patients presenting with fever and concomitant severe abdominal pain and shortness of breath, as any delay in timely institution of treatment can prove fatal. There are very few case reports in the world which have depicted this unusual association.Bangladesh Crit Care J March 2015; 3 (1): 36-38

scholarly journals The Salmonella enterica Serovar Typhi Type IVB Self-Association Pili Are Detached from the Bacterial Cell by the PilV Minor Pilus Proteins

2006 ◽  
Vol 74 (9) ◽  
pp. 5414-5418 ◽  
Author(s):  
Connie K. P. Tam ◽  
Christina Morris ◽  
Jim Hackett
Keyword(s):  
Typhoid Fever ◽  
Bacterial Cell ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Dna Supercoiling ◽  
Bacterial Membrane ◽  
Salmonella Enterica Serovar Typhi ◽  
Protein Molecules ◽  
Dna Fragment ◽  
Self Association

ABSTRACT Salmonella enterica serovar Typhi and some strains (Vi+) of serovar Dublin use type IVB pili to facilitate bacterial self-association, but only when the PilV proteins (potential minor pilus proteins) are not synthesized. Pilus-mediated self-association may be important in the pathogenesis of enteric fever. We have shown previously that the extent of DNA supercoiling controls the rate of Rci-catalyzed inversion of a DNA fragment which includes the C-terminal portions of the PilV proteins. This inversion therefore controls PilV synthesis as a high inversion rate prohibits transcription of pilV-encoding DNA. Here, we describe the manner in which PilV protein expression inhibits bacterial self-association and present data which suggest that incorporation of one or a few PilV protein molecules into a growing pilus, comprised of PilS subunits, causes the pilus to detach at the bacterial membrane. The bacteria are then unable to self-associate. We suggest that this phenomenon may be relevant to the pathogenesis of typhoid fever.

scholarly journals Ciprofloxacin treatment failure in a case of typhoid fever caused by Salmonella enterica serotype Paratyphi A with reduced susceptibility to ciprofloxacin

2007 ◽  
Vol 56 (2) ◽  
pp. 277-279 ◽  
Author(s):  
Tzonyo Dimitrov ◽  
Edet E. Udo ◽  
Osama Albaksami ◽  
Abdul A. Kilani ◽  
El-Din M. R. Shehab
Keyword(s):  
Typhoid Fever ◽  
Treatment Failure ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Susceptibility Testing ◽  
Laboratory Methods ◽  
New Guidelines ◽  
Oral Ciprofloxacin

This report describes a case of ciprofloxacin treatment failure in a patient with enteric fever caused by Salmonella enterica serotype Paratyphi A. The organism was isolated from a blood culture from a patient who was treated with oral ciprofloxacin (500 mg every 12 h) for 13 days. The organism showed reduced susceptibility to ciprofloxacin (MIC 0.75 μg ml−1) and was resistant to nalidixic acid. The patient was then placed on intravenous ceftriaxone (1 g every 12 h) and responded within 3 days. The patient was discharged after 9 days on ceftriaxone with no relapse on follow-up. This case adds to the increasing incidence of treatment failures with ciprofloxacin in typhoid fever caused by typhoid salmonellae with reduced susceptibility to ciprofloxacin. It also highlights the inadequacy of current laboratory methods for fluoroquinolone susceptibility testing in adequately predicting in vivo activity of ciprofloxacin against typhoid salmonellae and supports calls for new guidelines for fluoroquinolone susceptibility testing of these organisms.

scholarly journals Salmonella enterica Serovar Paratyphi C Carries an Inactive Shufflon

2004 ◽  
Vol 72 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Connie K. P. Tam ◽  
Jim Hackett ◽  
Christina Morris
Keyword(s):  
Typhoid Fever ◽  
Base Pair ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Terminal Region ◽  
Inverted Repeats ◽  
Single Base ◽  
Single Base Pair ◽  
Self Association ◽  
Base Pair Insertion

ABSTRACT Salmonella enterica serovar Typhi uses type IVB pili to facilitate bacterial self-association, but only when the PilV proteins (potential minor pilus proteins) are not synthesized. This pilus-mediated event may be important in typhoid fever pathogenesis. We initially show that S. enterica serovar Paratyphi C strains harbor a pil operon very similar to that of serovar Typhi. An important difference, however, is located in the shufflon which concludes the pil operon. In serovar Typhi, the Rci recombinase acts upon two 19-bp inverted repeats to invert the terminal region of the pilV gene, thereby disrupting PilV synthesis and permitting bacterial self-association. In serovar Paratyphi C, however, the shufflon is essentially inactive because each of the Rci 19-bp substrates has acquired a single base pair insertion. A PilV protein is thus synthesized whenever the pil operon is active, and bacterial self-association therefore does not occur in serovar Paratyphi C. The data thus suggest that serovar Typhi bacterial self-association using type IVB pili may be important in the pathogenesis of epidemic enteric fever.

scholarly journals Clinical Profile and Sensitivity Pattern of Salmonella Serotypes in Children: A Hospital Based Study

2011 ◽  
Vol 31 (3) ◽  
pp. 180-183 ◽  
Author(s):  
BG Joshi ◽  
K Keyal ◽  
R Pandey ◽  
BM Shrestha
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Wide Spectrum ◽  
Clinical Profile ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Sensitivity Pattern ◽  
Study Results ◽  
Culture Positive

Introduction: Enteric fever is a systemic infection caused by the bacteria, Salmonella enterica serovar Typhi (S.typhi) and Salmonella enterica serovara Paratyphi (S. paratyphi A, B and C). Most of the burden of the disease is limited to the developing world and the disease still has the issues like wide spectrum of clinical presentation and multidrug resistance. Objectives: This study was done to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive enteric fever. Methods: A prospective cross-sectional study was conducted in Civil Service Hospital from February 2010 to January 2011 in the paediatric population in the age group of 2 to 14 years. Children with Salmonella species isolated in blood culture were included in the study. Results: Out of the 40 children with culture positive enteric fever, male to female ratio was 1.3:1 with common age group between 11-14 years. S typhi was isolated in 25 cases while S. paratyphi in 15 cases. Clinical features of S. typhi and S. paratyphi were indistinguishable. Both S.typhi and S. paratyphi were found to be 100% sensitive to drugs like Ceftriaxone, Cefotaxime, Cefixime and Chloramphenicol. Sensitivity to Ofloxacin was 100% in S. paratyphi and 92% in S.typhi. Similarly sensitivity of Azithromycin was 92% and 93% for S.typhi and S. paratyphi respectively. Conclusion: Salmonella serotype is still 100 % sensitive to third generation cephalosporin. Some percentage of resistance is seen with Ofloxacin in S. typhi and with Azithromycin in both S.typhi and S. paratyphi. Key words: Enteric fever; S.typhi; S.paratyphi; Sensitivity DOI: http://dx.doi.org/10.3126/jnps.v31i3.4382 J Nep Paedtr Soc 2011;31(3): 180-183

scholarly journals Study on ultrasound observations in children with typhoid fever in a tertiary care hospital

2020 ◽  
Vol 7 (2) ◽  
pp. 428
Author(s):  
Zubair Ahamed Md. ◽  
Gangadhar B. Belavadi
Keyword(s):  
Typhoid Fever ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Wall Thickening ◽  
Age Difference ◽  
Care Hospital ◽  
College Hospital ◽  
Laboratory Findings ◽  
Female Ratio ◽  
Elevated Liver Enzymes

Background: Enteric fever continues to be endemic in poor countries globally, although it has been eradicated from the developed nations due to their well-organized sanitation and protected water supply. The five Fs most concerned with spread of typhoid disease are fingers, food, fomites, flies, and feces. Enteric fever is predominantly caused by Salmonella typhi and next in frequency is Salmonella paratyphi. Very less literature is available on radiological manifestations of typhoid fever in children on the basis of age difference in India. Hence, a study was conducted to observe the radiological findings and to correlate with laboratory manifestations in typhoid fever. Objectives of the study was to observe the ultrasound abdomen changes in Typhoid fever at rural area.Methods: The current study was conducted at Department of pediatrics of Narayana Medical College Hospital, Nellore, Andhra Pradesh state in a period of one year. All patients presenting with fever having positive for Widal test were included. In total 50 patients were included and divided into 2 age groups, <5 years and >5years. The laboratory results and abdominal ultrasound were conducted in the two groups and compared.Results: Total 20 patients in <5 years age and 30 patients in >5 years were enrolled. Male to female ratio was 2:1 in both groups. Common laboratory findings showed 32 patients (64%) with Anemia, elevated liver enzymes in 40 patients (80%), and elevated ESR in 42 patients (84%). 45 patients have Splenomegaly and hepatomegaly with normal parenchymal echotexture. Gallbladder sludge and biliary sludge was seen in 6 patients. Thickened gall bladder in 34 patients (68%) was observed. Bowel wall thickening seen in 32 patients (64%). mesenteric lymphadenopathy in 36 patients (68%) observed. All were recovered by treatment.Conclusions: On ultrasound, splenomegaly, hepatomegaly, and thick-walled gallbladder were observed in most of the childrens with typhoid fever. Therefore, ultrasound can also be used as supportive diagnose along with laboratory parameters due to it is a non-invasive and economical tool of diagnosing typhoid.

scholarly journals Abdominal Tuberculosis in Nepal Medical College Teaching Hospital, Kathmandu

2010 ◽  
Vol 5 (1) ◽  
pp. 39-42 ◽  
Author(s):  
S Shrestha ◽  
GB Pradhan ◽  
K Bhoomi ◽  
BL Shrestha ◽  
CL Bhattachan
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Pulmonary Tuberculosis ◽  
Teaching Hospital ◽  
Barium Meal ◽  
College Teaching ◽  
Abdominal Tuberculosis ◽  
Common Finding ◽  
Medical College ◽  
Acid Fast Bacilli

Abdominal Tuberculosis is a common extra pulmonary manifestation of tuberculosis. The wide spectrum of presentation makes abdominal tuberculosis difficult to diagnose and treat. Retrospective review of cases with abdominal tuberculosis presenting to the Surgery Department of Nepal Medical College Teaching Hospital from January 2002- June 2007 was done to describe our experience of abdominal tuberculosis over a 5 year period. We found total 32 patients with abdominal tuberculosis, among which 13 had concurrent pulmonary tuberculosis. The most common clinical presentation, i.e. a triad of abdominal pain, fever and weight loss was present in 13 who had symptoms of pulmonary tuberculosis presented to physicians and the remaining 19 presented acutely to surgeons with symptoms of pain and obstruction. Chest X ray, abdominal ultrasound and barium meal follow through done to find associated abnormalities. Diagnostic Laparoscopy was performed in 10 and 3 patients with peritonitis underwent emergency laparotomy which revealed multiple ileal perforations in 2 cases and one had multiple strictures with small bowel perforation. Diagnosis of tuberculosis, attended at surgeons was confirmed by demonstrating caseating granulomas in histology and Acid Fast Bacilli Positive, culture for M. tuberculosis from peritoneal fluid. All patients were started anti tuberculosis treatment. Abdominal tuberculosis is a relatively common finding and should always be considered in the differential diagnosis of abdominal pain, fever and weight loss. Key Words: Tuberculosis; abdominal tuberculosis; Acid Fast Bacilli; ileocaecal disease DOI: 10.3126/saarctb.v5i1.3083 SAARC J. Tuber. Lung Dis. HIV/AIDS 2008 Vol.5(1) 39-42

Fuzzy Expert Framework for Diagnosis of Typhoid

2017 ◽  
Vol 2 (9) ◽  
pp. 13-16
Author(s):  
Okpokpong Nathaniel Ntebong Celestine ◽  
Umar Farouk Ibn Abdulrahman ◽  
Itoro Akpabio
Keyword(s):  
Fuzzy Logic ◽  
Abdominal Pain ◽  
Typhoid Fever ◽  
Membership Function ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Medical Complications ◽  
Inference Rules ◽  
Membership Functions ◽  
Centroid Method

Typhoid fever is a disease that is caused by bacteria called salmonella typhi. It is also known as Enteric fever, Typhoid fever is been characterized by high fever, constipation, diarrhoea, abdominal pain, etc. It is often treatable when diagnosed early, but if left untreated could lead to other medical complications like intestinal haemorrhaging which may require major surgeries and could even lead to death. This paper proposes a method of diagnosis of Typhoid Fever using Fuzzy Logic. The system was built with twenty input membership functions, one output membership function and about two hundred inference rules which was simulated with MATLAB R2013 and therefore 97.5 % accuracy was obtained. The centroid method was used for the defuzzification. Although there are many systems in existence, this work is however based on the assumption that a system with a higher number of inference rules will make diagnosis a better.

scholarly journals A Review on Recent Developments for the Cure of Salmonella Enterica Serovar Typhi, the Causative Agent for Typhoid Fever

2020 ◽  
Vol 1 (2) ◽  
pp. 1-8
Author(s):  
Muqadas Kanwal ◽  
Fadia Waheed ◽  
Hafsa Shahzadi ◽  
Muhammad Shahbaz ◽  
Ahsan Noor
Keyword(s):  
Typhoid Fever ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Ethical Issues ◽  
Age Groups ◽  
Human Infection ◽  
Health Concern ◽  
Typhoid Vaccine ◽  
The World

Salmonella enterica typhi is typhoid or enteric fever agent which is a serious water-borne disease and is a human host restricted organism. So, an important cause of death in underdeveloped countries, typhoid fever is a public health concern. Worldwide, 15-30 million people suffer from this disease every year, causing more than 200,000 deaths. However, several lines of evidence suggest that the advent of multidrug-resistant non-typhoidal strains of Salmonella has an important impact on the effectiveness of current strategies, including reductions in the effectiveness of early empirical treatment for controlling and managing foodborne diseases. Recent studies show more than 2000 strains of salmonella bacteria with around 100 strains connected to human infection - with myriad common strains from Salmonella Heidelberg to Typhimurium to Salmonella infantis. The multi-medicinal strain S. Typhi H58 has developed into the main circulating strain in many parts of the world, and an extensively drug-resistant (XDR) subclade has been recently found. Most of the people agree that the most effective way to control infection is to vaccinate susceptible populations. The commercially available live attenuated (Ty21a) vaccine, on the other hand, is not recommendable for children under the age of six, whereas the poor long-term efficacy of Vi-polysaccharide-based vaccine against typhoid fever. Furthermore, there are no vaccines available to protect against S. para typhi infection. Subsequently, a new formulation is urgently needed that can provide long-term protection against both pathogens while healthy for all age groups. Pakistan is the first country in the world to incorporate the WHO-recommended conjugate vaccine into its routine typhoid immunization program (2019). As a result, the purpose of this review is to describe the various diagnostic procedures for typhoid fever diagnosis and cure development. This article addressed some of the elements and components required for the implementation of typhoid vaccine. With an analysis of past and current enteric fever vaccines in progress as well as the ethical issues relevant to CHIM in typhoid vaccine efficacy research, we have combined the new methods to predict typhoid burden and vaccines impact.

scholarly journals Clinical Profiles and Endoscopic Findings of Patients Undergoing Colonoscopy in Nobel Medical College

2019 ◽  
Vol 8 (1) ◽  
pp. 3-7
Author(s):  
Rishab Shrestha ◽  
Alisha Rajbhandari ◽  
Gaurav Chhetri ◽  
Rejina Shahi Regmi ◽  
Pradip Chaudhary
Keyword(s):  
Ulcerative Colitis ◽  
Abdominal Pain ◽  
College Teaching ◽  
Invasive Procedure ◽  
Cross Sectional Study ◽  
Chronic Abdominal Pain ◽  
Common Finding ◽  
Chronic Diarrhoea ◽  
Cross Sectional ◽  
Medical College

Background: Colonoscopy is an invasive procedure used both diagnostically and therapeutically. Direct visualization and real-time image of entire large colon and distal terminal ileum makes it superior. Patients are unable to undergo colonoscopy because of the limitation in the developing country. Moreover, limited studies are available in our country regarding the colonic diseases. Materials and Methods: It was a descriptive cross-sectional study done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to December 2018. Approval was acquired from Institutional Review Committee. All patients undergoing colonoscopy in the hospital was included. After taking proper consent, bowel preparation, premedications, colonoscopy was performed, findings noted in pro-forma. Results: Of the total 176 patients 119 (67.60%) were male and 57 (32.40%) were female; mean age 46.98 ± 17.13 years. Indication for performing colonoscopy was chronic diarrhea in 58(33.0%), chronic abdominal pain in 47(26.70%). Significant lesion observed in 142 patients (80.68%); colitis with unspecified etiology in 69 (39.20%), ulcerative colitis in 28 (15.90%), crohn’s disease in 13(7.38%).Colitis was more in male 46(66.67%) and involving rectum was common. Pan-ulcerative colitis was common seen in 11patients (39.28%). Conclusion: Chronic diarrhoea and chronic abdominal pain were two common indications. Male patients were in higher prevalence opting for colonoscopy. Colitis of unspecified etiology of rectum and ileo-cecal region was most common finding. Ulcerative colitis involving whole of colon and younger age group was predominantly affected.

Sign in / Sign up

Export Citation Format

Share Document