Clinical profile of culture proven enteric fever in children at university teaching hospital, Nepal

Abstract

Introductions: Enteric fever is one of the major public health issues in Nepal.
The present study was designed to analyze the clinical profile and antibiotic
sensitivity pattern in the cases of culture positive typhoid fever.

Methods: This is a cross sectional study done by reviewing the hospital
record files of children admitted in paediatric ward of Patan Hospital with
culture positive enteric fever over a period of seven years from January
2007 to December 2013. The mode of presentation, sensitivity pattern of
isolates from blood culture, response to therapy and the complications were
recorded and analyzed.

Results: There were total of 119 culture positive enteric fever admitted to
children ward during this period, 64 (53.7%) males and 55 (46.3%) females.
Common symptoms were fever (100%), Common symptoms were fever
(100%), vomiting 37 (31.09%), diarrhea 27 (22.68%), abdominal pain 31
(26%) cough 24 (20%), and constipation six (5%). Common clinical signs
were hepatomegaly 41 (34.4%), splenomegaly 25 (21%), and chest signs 10
(8.4%). Sensitivity to ceftriaxone was 96.6% in this study. Ninety four percent
of salmonella typhi in 2013 were resistant to quinolones.

Conclusions: Apart from fever, diarrhea, vomiting, abdominal pain and cough
were major manifestations and encephalopathy was common complication
of enteric fever in this study. Resistance to many of the drugs are emerging.
An appropriate antibiotic has to be initiated only after culture sensitivity in
typhoid fever.

Keywords: clinical profile, enteric fever, salmonella typhi