Demographic and clinical profile of enteric fever admitted to a medical unit of a tertiary referral centre in Sri Lanka
Abstract
Objectives: To study the demographics and clinical features of enteric fever patients admitted to a medical unit of a tertiary referral centre in Sri Lanka
Method: Clinical notes of 114 patients diagnosed as having enteric fever admitted to the principal author’s unit at Sri Jayawardenepura General Hospital, Kotte, Sri Lanka from January 2011 to June 2012 were retrospectively analyzed to obtain the required data.
Results: Age range was 12-82 years with a mean age of 35+/- 14.0 SD. Sex distribution male: female =78:36 (2:1). Fever, abdominal pain, diarrhea, headache and constipation were present in 100%, 36.0%, 26.4%, 9.6% and 9.0% of instances respectively. Paratyphoid and typhoid serology were positive in 48.2%and 51.1% respectively. Anicteric hepatitis was found in 73.7%. Inflammatory markers (ESR and/or C-RP) were elevated only in 42.1%.Thrombocytopenia (<150,000mm) was found in 25.1%. Abdominal ultrasound showed hepatic, splenic and gall bladder involvement in 31.8%, 27.3% and 10.1% of instances respectively. Blood cultures were positive only in 47.2%. Ceftriaxone resistance was seen in 3.5%. Acute transverse myelitis was seen in one patient. The classically described ‘step ladder’ fever pattern, doughy abdomen and rose spots were not observed.
Conclusion: A male dominance was noted. Hepatobilliary involvement was asymptomatic. Response to antibiotics and a falling Salmonella antibody titre confirmed diagnosis in culture negative patients. Pretreatment with antibiotics in the community could have influenced the clinical picture, serology and culture positivity.
