Aline Tohme1, Emile Zein, Roy Nasnas. 1. Service de Médecine interne et maladies infectieuses, Hôtel-Dieu de France-Beyrouth, Faculté de médecine, Université Saint-Joseph, Beyrouth. atohme2@inco.com.lb
Abstract
OBJECTIVE: Present clinical features of typhoid fever in Lebanon. METHODS: Retrospective study of 70 patients admitted to a university hospital center between 1995 and 2002. The criteria for inclusion were a positive Salmonella typhi or paratyphi hemoculture and/or a Widal serodiagnosis > or = 1/160 for O agglutinin, in the presence of evocative symptoms. RESULTS: Among the 70 patients, 25 pediatric cases were noted. The patients were aged a mean of 28+/-22 years. Average duration of symptoms before the diagnosis was 10+/-7 days. Fever were observed in 97% of cases and the other predominant symptoms were abdominal pain (41%), diarrhoea (36%), chills (31%) and headache (29%). Febrile gastroenteritis was a frequent manifestation in children (52%). Complications were noted in 31% of cases and were predominantly digestive. Leucopenia was not a helpful diagnostic marker. S. typhi was the most frequent (87%) serotype identified. Resistance to ampicilline was 10%, to cotrimoxazole and chloramphenicol 7% for each and to ofloxacine 2%. One death was reported (1%) of an immunosuppressed patient. CONCLUSION: Typhoid fever is still an endemic disease in Lebanon and should be systematically evoked in the case of prolonged fever, febrile gastroenteritis and/or headache. The appearance of bacteria resistant to antibiotics makes ceftriaxone or ciprofloxacine the empirical treatment of choice.
OBJECTIVE: Present clinical features of typhoid fever in Lebanon. METHODS: Retrospective study of 70 patients admitted to a university hospital center between 1995 and 2002. The criteria for inclusion were a positive Salmonella typhi or paratyphi hemoculture and/or a Widal serodiagnosis > or = 1/160 for O agglutinin, in the presence of evocative symptoms. RESULTS: Among the 70 patients, 25 pediatric cases were noted. The patients were aged a mean of 28+/-22 years. Average duration of symptoms before the diagnosis was 10+/-7 days. Fever were observed in 97% of cases and the other predominant symptoms were abdominal pain (41%), diarrhoea (36%), chills (31%) and headache (29%). Febrile gastroenteritis was a frequent manifestation in children (52%). Complications were noted in 31% of cases and were predominantly digestive. Leucopenia was not a helpful diagnostic marker. S. typhi was the most frequent (87%) serotype identified. Resistance to ampicilline was 10%, to cotrimoxazole and chloramphenicol 7% for each and to ofloxacine 2%. One death was reported (1%) of an immunosuppressed patient. CONCLUSION:Typhoid fever is still an endemic disease in Lebanon and should be systematically evoked in the case of prolonged fever, febrile gastroenteritis and/or headache. The appearance of bacteria resistant to antibiotics makes ceftriaxone or ciprofloxacine the empirical treatment of choice.