scholarly journals Enteric fever with severe pancytopenia in a four year girl

2010 ◽  
Vol 50 (180) ◽  
Author(s):  
R Pathak ◽  
A Sharma ◽  
A Khanal
Keyword(s):  
Bone Marrow ◽  
Enteric Fever ◽  
Hemophagocytic Syndrome ◽  
Systemic Infection ◽  
Salmonella Typhi ◽  
Bone Marrow Suppression ◽  
Major Health Problem ◽  
Major Health ◽  
Severe Pancytopenia ◽  
Paratyphoid Fever

Typhoid fever and paratyphoid fever (also known as enteric fever) are severe systemic illnesses caused by salmonella typhi and S. paratyphi respectively. Enteric fever is prevalent in developing countries including Nepal, where it still remains as a major health problem. There have been reports of pancytopenia with enteric fever which has been attributed to mechanisms like bone marrow suppression, infection associated hemophagocytic syndrome and disseminated intravascular coagulation. We report here a case of severe pancytopenia in enteric fever as a result of bone marrow suppression due to systemic infection. Keywords: enteric fever, pancytopenia, bone marrow suppression

scholarly journals CLINICOPATHOLOGICAL PROFILE OF SALMONELLA TYPHI AND PARATYPHI INFECTIONS PRESENTING AS FEVER OF UNKNOWN ORIGIN IN A TROPICAL COUNTRY.

2015 ◽  
Vol 7 ◽  
pp. e2015021
Author(s):  
Nayyar Iqbal ◽  
Aneesh Basheer ◽  
Sudhagar Mookkappan ◽  
Anita Ramdas ◽  
Renu G'Boy Varghese ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Enteric Fever ◽  
Fever Of Unknown Origin ◽  
Clinical Laboratory ◽  
Febrile Illness ◽  
Unknown Origin ◽  
Salmonella Typhi ◽  
Common Symptom ◽  
Tropical Country ◽  
The Tropics

Background: Enteric fever, a common infection in the tropics and endemic to India, often manifests as an acute febrile illness. However, presentation as fever of unknown origin (FUO) is not uncommon in tropical countries. Methods: We aim to describe the clinical, laboratory and pathological features of cases hospitalized with fever of unknown origin and diagnosed as enteric fever. All culture proven cases of enteric fever were analyzed retrospectively over a period of three years from January 2011 to December 2013.Results: Seven of 88(8%) cases with enteric fever presented as FUO. Abdominal pain was the most common symptom besides fever. Relative bradycardia and splenomegaly were uncommon. Thrombocytopenia was the most common haematological abnormality, while leucopenia was rare. Transaminase elevation was almost universal. S.Typhi and S.Paratyphi were isolated from six cases and one case respectively.  Yield of organisms from blood culture was superior to that of bone marrow aspirate. Multiple granulomas were identified in 4 out of 6 (67%) of the bone marrows studied, including that due to S. Paratyphi and histiocytic hemophagocytosis was noted in two cases.Conclusion: FUO is a relatively common manifestation of enteric fever in the tropics. Clinical and laboratory features may be atypical in such cases, including absence of relative bradycardia, leucopenia and presence of thrombocytopenia, bicytopenia or pancytopenia.  Moreover, in endemic countries, enteric fever should be considered as a differential diagnosis, next to tuberculosis, in the evaluation of bone marrow granulomas in cases with FUO and culture correlation should be mandatory.

scholarly journals Epidemiology of Typhoid and Paratyphoid Fever in Kathmandu : Two Years Study and Trends of Antimicrobial Resistance

2005 ◽  
Vol 44 (157) ◽  
Author(s):  
S Malla ◽  
P Kansakar ◽  
Serichantalergs Serichantalergs ◽  
M Rahman ◽  
S Basnet
Keyword(s):  
Antimicrobial Resistance ◽  
Enteric Fever ◽  
Tetracycline Resistance ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Diffusion Technique ◽  
Plasmid Analysis ◽  
Paratyphoid Fever

Enteric fever is prevalent in developing countries including Nepal, where it still remains as a major healthproblem. Appropriate antibiotics are essential for the treatment of typhoid and paratyphoid fever. Aprospective study was carried out to characterize the epidemiological features of enteric fever in Kathmandu,Nepal and to analyse the recent trend of antimicrobial resistance pattern of the Salmonella isolated from thecases of enteric fever from different hospitals in Kathmandu during June, 2002 to June, 2004. A total of 1469Salmonella typhi and Salmonella paratyphi ‘A’ isolates collected during this period from five different hospitallaboratories situated in Kathmandu were studied. The antimicrobial susceptibilities of the isolates towardsAmpicillin (10mcg), Chloramphenicol (30mcg), Cotrimoxazole (25mcg), Ciprofloxacin (5mcg) and Ceftriaxone(5mcg) were determined by standard disc diffusion technique and Agar dilution technique were used todetermine the minimum inhibitory concentration (MIC) for Ampicillin, Ciprofloxacin, Chloramphenicoland Ceftriaxone. All the isolates tested were found to be sensitive to Ceftriaxone and Ciprofloxacin, the mostcommonly used antibiotic for treatment of enteric fever in Nepal. Of the total isolates studied, 15.5% from2002, 8% from 2003 and 3.45% from 2004 were found to be multidrug resistant (exhibiting resistance towardsAmpicillin, Chloramphenicol and Cotrimoxazole). Of the total multi drug resistant Salmonella isolates, 92%were Salmonella typhi. All the multidrug resistant isolates were also further tested for susceptibilities towardsTetracycline (30mcg), Nalidixic acid (30 mcg), Streptomycin (10units), Gentamycin (25mcg), Azithromycin(15mcg), Kanamycin (30mcg), Neomycin (30mcg). 50% of the multi drug resistant Salmonella typhi werealso resistant to Tetracycline. Plasmid analysis revealed that all of the Mutidrug resistant Salmonella typhiisolates with Tetracycline resistance harbored a large molecular weight (147 Kb) plasmid.Key Words: Enteric fever, Salmonella, Antibiotic, Plasmid, Multidrugresistant

scholarly journals Feminization and severe pancytopenia caused by testicular neoplasia in a cryptorchid dog

2016 ◽  
Vol 85 (4) ◽  
pp. 197-205 ◽  
Author(s):  
D. Paepe ◽  
L. Hebbelinck ◽  
A. Kitshoff ◽  
S. Vandenabeele
Keyword(s):  
Bone Marrow ◽  
Early Stage ◽  
Fatal Outcome ◽  
Clinical Signs ◽  
Testicular Tumor ◽  
Bone Marrow Suppression ◽  
Blood Levels ◽  
Intact Male ◽  
Initial Improvement ◽  
Severe Pancytopenia

In this case report, a paraneoplastic syndrome caused by testicular neoplasia in a ten-year-old cryptorchid dog is described. Feminization and pancytopenia were observed, resulting from the testicular neoplastic production of estrogens. A diagnosis of testicular tumor and associated bone marrow suppression was made by ultrasonography and blood examination, with estrogen blood levels being severely elevated. Urinalysis revealed a urinary tract infection. Castration was performed together with a blood transfusion, and antibiotic treatment was started. After an initial improvement, the dog died suddenly after approximately three weeks. In this report, the importance is highlighted of identifying clinical signs associated with feminization in intact male dogs at an early stage, to avoid severe, potentially irreversible, hematological consequences due to bone marrow suppression. Elective orchidectomy of both testes is highly recommended in cryptorchid dogs as neoplastic transformation of the undescended testis may occur, with potentially fatal outcome.

scholarly journals A review of clinical profile, complications and antibiotic susceptibility pattern of extensively drug-resistant (XDR) Salmonella Typhi isolates in children in Karachi.

2020 ◽  
Author(s):  
Saba Shahid ◽  
Marvi Mahesar ◽  
Nida Ghouri ◽  
Saba Noreen
Keyword(s):  
Enteric Fever ◽  
Clinical Course ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
Systemic Infection ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Salmonella Typhi ◽  
Drug Resistant ◽  
Extensively Drug Resistant

Abstract Background: Enteric fever is a systemic infection, which can be caused by Salmonella enterica; Typhi and Paratyphi A. Over time, Salmonella Typhi has developed resistance to antibiotics resulting in the emergence of extensively drug-resistant (XDR) enteric fever. WHO estimated 5274 cases of XDR Enteric fever in Karachi from November 2016 to December 2019. This study aims to determine clinical course, complications and outcomes of XDR enteric fever among the pediatric population coming to Indus HospitalMethods: A retrospective chart review of pediatric patients (aged one month to 15 years) seen in Indus Hospital between July 2017 to December 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about seasonality and distribution of cases, demographic details, signs and symptoms, clinical course, treatment, complications and outcomes of the cases treated for XDR Enteric feverResults: Six hundred and eighty children were included in the study. The median (IQR) age of the patients was 5 (2-8) years. More than half (n=391, 57.5%) of the patients were males. Most common clinical manifestations included fever, vomiting and diarrhea, noted in 680 (100%), 242 (35%) and 174 (25%) patients. Outcomes of 270 (39.7%) patients were recorded. Others were lost to follow up [351 (51.6%)], referred out [52 (7.6%)] or left against medical advice [7 (1%)]. 266 (39.1%) patients were cured, and four children (0.6%) expired. Seventy-eight patients (82%) and 15 patients (16.3%) got cured on Azithromycin and Meropenem alone while 157 on a combination of drugs.Conclusion: Our review indicated that children under five years of age were affected more with XDR Enteric fever. Meropenem and Azithromycin, either alone or in combination were the most effective antibiotics for treating XDR Enteric fever in children coming to Indus hospital

scholarly journals Case Report of Typhoid Fever (Salmonella typhi)

2021 ◽  
pp. 55-59
Author(s):  
Archana Dhengare ◽  
Savita Pohekar ◽  
Prerana Sakharwade ◽  
Sheetal Sakharkar ◽  
Samrudhi Gujhar ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Water Supply ◽  
Therapeutic Intervention ◽  
Enteric Fever ◽  
Gastrointestinal Symptoms ◽  
Salmonella Typhi ◽  
Fluid Replacement ◽  
Major Health Problem ◽  
Matter System ◽  
Sewage Waste

Typhoid fever is a major health problem globally. Typhoid fever is an enteric fever characterized by systemic illness along with abdominal pain and fever in a "step-ladder" pattern. Typhoid fever is one of the major causes of mortality and morbidity in overcrowded and unhygienic areas though comprehensive research and public health interventions have decreased the occurrence. Patient is having sign symptoms as gastrointestinal symptoms, malaise, hepatomegaly, and high liver enzymes presented with a two-week fever. As a differential diagnosis, a Widal test  is done and two blood cultures were requested; both came out positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Treatment with ceftriaxone and metronidazole was stared prior to confirmation of the diagnosis, with a partial response; later, pharmacological therapy was altered based on ciprofloxacin susceptibility testing, with a satisfactory clinical response. We look at how to diagnose and treat enteric fever, with an importance to typhoid fever. Symptoms or important clinical finding:- A 6 year old male was admitted in A.V.B.R.H on date 12/03/2021 with chief complaint of abdominal discomfort, malaise, problems such as  fever since 2 weeks, gastrointestinal symptoms, lethargy, hepatomegaly, and an increased liver enzyme. Diagnosis therapeutic intervention and outcome: A case is diagnosed as Typhoid Fever. After physical examination and investigation, doctor was detected a case of 6 week. Therapeutic intervention and outcome: Also provide a calcium supplements and iron supplements present case was stable but according to ultrasonography finding. Outcome- Good sanitation, improved water supply, and a suitable sewage waste matter system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever. Nursing Perspective: Administration fluid replacement .i.e DNS and RL monitored vital signs per hourly. Maintained temperature chart 2 hourly strictly, maintained intake output chart properly. Tablet paracetamol, antibiotics given as per doctor’s order. Conclusion: Good sanitation, improved water supply, and a suitable sewage waste matter  system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever.

scholarly journals Fluoroquinolone-resistant Salmonella typhi infection: a report of two cases in South Africa

2018 ◽  
Vol 33 (2) ◽  
pp. 54-56
Author(s):  
N. Schellack ◽  
E. Bronkhorst ◽  
C. Maluleka ◽  
L. Hunt ◽  
P. Srinivas ◽  
...  
Keyword(s):  
South Africa ◽  
Salmonella Enterica ◽  
Systemic Infection ◽  
Salmonella Typhi ◽  
Fluoroquinolone Resistance ◽  
Life Threatening ◽  
Paratyphoid Fever

Typhoid and paratyphoid fever are acute, life-threatening febrile illnesses caused by systemic infection with the bacterium Salmonella enterica. Nineteen cases were reported in South Africa in 2016. We report on two cases of bacteraemic invasive S. typhi with fluoroquinolone resistance.

scholarly journals Development of Moore Swab and Ultrafiltration Concentration and Detection Methods for Salmonella Typhi and Salmonella Paratyphi A in Wastewater and Application in Kolkata, India and Dhaka, Bangladesh

2021 ◽  
Author(s):  
Pengbo Liu ◽  
Makoto Ibaraki ◽  
Renuka Kapoor ◽  
Nuhu Amin ◽  
Abhishek Das ◽  
...  
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Limit Of Detection ◽  
Systemic Infection ◽  
Salmonella Typhi ◽  
Detection Methods ◽  
Quantitative Detection ◽  
Surveillance Strategy ◽  
Wastewater Samples ◽  
Polyethylene Glycol Precipitation

AbstractEnteric fever is a severe systemic infection caused by Salmonella enterica serovar Typhi (ST) and Salmonella enterica serovar Paratyphi A (SPA). Detection of ST and SPA in wastewater can be used as a surveillance strategy to determine burden of infection and identify priority areas for water, sanitation, and hygiene interventions and vaccination campaigns. However, sensitive and specific detection of ST and SPA in environmental samples has been challenging. In this study, we developed and validated two methods for concentrating and detecting ST/SPA from wastewater: the Moore swab trap method for qualitative results, and ultrafiltration (UF) for sensitive quantitative detection, coupled with qPCR. We then applied these methods for ST and SPA wastewater surveillance in Kolkata, India and Dhaka, Bangladesh, two enteric fever endemic areas. The qPCR assays had a limit of detection of 17 equivalent genome copies (EGC) for ST and 25 EGC for SPA with good reproducibility. In seeded trials, the Moore swab method had a limit of detection of approximately 0.05-0.005 cfu/mL for both ST and SPA. In 53 Moore swab samples collected from three Kolkata pumping stations between September 2019 to March 2020, ST was detected in 69.8% and SPA was detected in 20.8%. Analysis of sewage samples seeded with known amount of ST and SPA and concentrated via the UF method, followed by polyethylene glycol precipitation and qPCR detection demonstrated that UF can effectively recover approximately 8 log10 cfu, 5 log10 cfu, and 3 log10 cfu of seeded ST and SPA in 5 L, 10 L, and 20 L of wastewater. Using the UF method in Dhaka, ST was detected in 26.7% (8/30) of 20 L drain samples with a range of 0.11-2.10 log10 EGC per 100 mL and 100% (4/4) of 20 L canal samples with a range of 1.02 - 2.02 log10 EGC per 100 mL. These results indicate that the Moore swab and UF methods provide sensitive presence/absence and quantitative detection of ST/SPA in wastewater samples, and these two methods can be used jointly or separately for Salmonella Typhi environmental surveillance.

scholarly journals Enteric fever in Scotland, 1967–1974

1976 ◽  
Vol 76 (1) ◽  
pp. 83-89 ◽  
Author(s):  
J. C. M. Sharp ◽  
C. S. Heymann
Keyword(s):  
Young Adults ◽  
United Kingdom ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Enteric Infection ◽  
Phage Types ◽  
The United Kingdom ◽  
Paratyphi B ◽  
Paratyphoid Fever ◽  
Imported Infections

SUMMARYA review of 194 cases of enteric infection in Scotland during 1967–74, is reported. Diagnosis was confirmed by the laboratory isolation of Salmonella typhi (64 cases), S. paratyphi A (3) and S. paratyphi B (127), from blood or faeces; 174 persons were clinically ill and 20 were symptomless infections.Most patients (81·0%) were under 35 years of age, with the highest incidence occurring among young adults of 15–24 years, many of whom had been travelling overseas. One-third of all cases (65) were imported infections; the remaining 129 patients had not been outside the United Kingdom. A significantly greater proportion of typhoid infection (54·7%) was contracted overseas, in contrast to paratyphoid B with only one-fifth of cases (21·2%) being imported; all three cases of paratyphoid A were imported. The geographic distribution of origin of imported infections is discussed, along with the frequency of organisms belonging to different phage types.Two deaths occurred, one of which was the result of complications of paratyphoid fever. All other patients responded well to treatment, although two persons continued to excrete and became chronic carriers.A few examples are given of episodes of particular epidemiological interest.It is expected that in future years there will be a continued increase in the proportion of imported infections as more persons travel overseas, concurrent with the continuing decline in the number of chronic carriers resident in the British Isles.

scholarly journals ENTERIC FEVER IN TRAVELERS: AN UPDATED INSIGHT

2016 ◽  
Vol 9 (9) ◽  
pp. 2
Author(s):  
Varshil Mehta
Keyword(s):  
Enteric Fever ◽  
Indian Subcontinent ◽  
Salmonella Typhi ◽  
New Drugs ◽  
Multi Drug Resistance ◽  
Exponential Rate ◽  
First Line ◽  
Broad Term ◽  
Paratyphoid Fever ◽  
First Line Treatment

ABSTRACTEnteric fever is a broad term used to represent typhoid and paratyphoid fever which is caused by S. typhi and S. paratyphi respectively. The mostcommon cause being S. typhi, overall. However, S. paratyphi is known to infect the travelers at a higher rate. Indian subcontinent being one of the mostendemic region, it is always beneficial for the travelers to get immunized while traveling to these areas. However, Vaccination to S. paratyphi is not yetavailable, hence travelers often fall prey to the disease. The morbidity is often high but mortality is very rare, especially due to first line treatment drugslike ceftriaxone, nalidixic acid and floroquinolones (if patients are sensitive to it). Recently, it was observed that Multi-drug resistance (Resistance to atleast ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole]) was limited to Typhi isolates and was increased at an exponential rate. Hence,with increasing resistance to these drugs, developing vaccines or new drugs against these bacteria, remains an area of prime interest.Keywords: Salmonella typhi, Salmonella paratyphi, Enteric fever, Traveler.

scholarly journals Hemophagocytic Syndrome in a Pancytopenic Simian Retrovirus–Infected Male Rhesus Macaque (Macaca mulatta)

2011 ◽  
Vol 48 (6) ◽  
pp. 1138-1143 ◽  
Author(s):  
T. M. Cotroneo ◽  
L. A. Colby ◽  
I. L. Bergin
Keyword(s):  
Bone Marrow ◽  
Rhesus Macaque ◽  
Hemophagocytic Syndrome ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Severe Pancytopenia ◽  
Retrovirus Infection ◽  
Macrophage Cytokine ◽  
Male Rhesus

Hemophagocytic syndrome (HPS) is a macrophage hyperactivation disorder triggered by disrupted T–cell macrophage cytokine interaction. HPS has been reported in humans, dogs, cats, and cattle, and it is infrequent and poorly characterized in animals. A 16-year-old male rhesus macaque was euthanized because of severe pancytopenia, including nonregenerative anemia (hematocrit = 5.5%), neutropenia (0.29 K/μl), and thrombocytopenia (21 K/μl). Bone marrow was hypocellular with normal maturation, myeloid hypoplasia, and few megakaryocytes. There were numerous morphologically normal macrophages (12% of nucleated cells), with 6% of nucleated cells being hemophagocytic macrophages in the bone marrow. Serology was negative, but polymerase chain reaction and immunohistochemistry were positive for simian retrovirus type 2. Blood and bone marrow findings were consistent with HPS. Cytopenias are common in simian retrovirus–infected macaques, but HPS has not been reported. An association between simian retrovirus infection and HPS is undetermined, but retrovirus-associated HPS has been observed in humans.

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