CLINICAL PROFILE OF ENTERIC FEVER IN CHILDREN.

Corresponding Author:
Dr. Narendra Laishram,
JN Institute of Medical Sciences,
Imphal.
E-mail: drlnarendra@gmail.com

ABSTRACT

BACKGROUND 

The protean manifestations of enteric fever make this disease a true diagnostic challenge. Untreated enteric fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation and death. This is a prospective study of ninety eight confirmed enteric fever children done in J N Institute of Medical Sciences, Imphal.

AIMS  

The present study was undertaken to determine the clinical profile and outcome of hospitalized children with enteric fever.

MATERIAL AND METHODS 

The study was conducted at Jawaharlal Nehru Institute of Medical Sciences, Imphal from January 2012 to December 2014. Total of ninety eight children between 1 year to 12 years of age who had clinical features strongly suggestive of typhoid fever and on Widal test and blood culture found to be positive for salmonella typhi were analysed for clinical features. Detailed history, comprehensive physical examination and other relevant information were recorded by following standard procedures.

RESULTS

There were total of 98 cases of typhoid fever admitted. Of the 98 children 59 (60.20%) were boys and 39 (39.79%) were girls, with male:female ratio of 1.51:1. The cases were common among the age group 7 year to 12 years 51 (52 %); 100% of children in our series were unimmunized against typhoid. Typhoid fever has bimodal peak occurrence in March/April and August/September. Most of the cases were from rural areas 60 (61.22%). Predominant symptoms were fever 98 (100%), headache 75 (76.53%), anorexia 80 (81.63%), vomiting 26 (26.53%), abdominal pain 68 (69.38%), diarrhea 37 (37.75%) and cough 26 (26.53%). Hepatomegaly was the most common sign seen among the cases and was seen in 76 cases (77.55%). Other common clinical signs were coated tongue 80(81.63%) and splenomegaly 38 (38.77%). Rose spots were not noticed. During the hospital stay, the most common antimicrobial used was intravenous Ceftriaxone. None of the patients presented with complications.

CONCLUSION

The clinical profile of enteric fever in our study revealed not much difference from that of other studies on enteric fever. There was not a single case of complication of enteric fever. Probably early initiation of antibiotics prevented the complications. Enteric fever is one of the common causes of fever in children with varied presentation and significant difference in the signs and symptoms compared to adults.

KEYWORDS

Salmonella, Enteric Fever, Typhoid, Children.