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Typhoid: Clinical picture and response to chloramphenicol

Prospective study in Bombay (1972)

Typhus abdominalis: Klinisches Bild und Therapie mit Chloramphenicol

Prospektive Studie in Bombay (1972)

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Summary

The clinical picture of 78 cases with proven typhoid and 18 cases with proven paratyphoid A fever is presented. The diagnosis was made by isolating the organisms from the blood. The Widal test could not be used as a diagnostic criterion. By means of chemotherapy with chloramphenicol (initial dose 30–40 mg/kg body weight) defervescence was achieved within an average of 4.5 days. The course of the disease was generally mild; one patient with typhoid fever died. The average hospital stay was 19 days. Four patients of the typhoid fever group were readmitted with a relapse. The laboratory examinations included blood clot culture, phage typing, Widal test, haemoglobin, leucocyte count, transaminases, serum bilirubin, and routine examination and culture of stool and urine. Forty-two patients were infected with intestinal parasites and 25 with Shigella organism. The findings are discussed and compared with findings of similar studies of enteric fever.

Zusammenfassung

Es wird über das klinische Bild von 78 Fällen mit nachgewiesenem Typhus abdominalis und 18 Fällen mit nachgewiesenen Paratyphus A berichtet. Die Diagnose wurde durch Isolierung der Erreger aus dem Blut gestellt. Der Widal-Test konnte nicht als diagnostisches Kriterium verwendet werden. Unter der Chemotherapie mit Chloramphenicol (Initialdosis von 30–40 mg/kg Körpergewicht) trat im Durchschnitt nach 4,5 Tagen Entfieberung ein. Der Krankheitsverlauf war im allgemeinen leicht. Ein Patient mit Typhus abdominalis verstarb. Die durchschnittliche Hospitalisierungsdauer betrug 19 Tage. Vier der Patienten mit Typhus abdominalis wurden mit einem Rückfall erneut hospitalisiert. Die Laboruntersuchungen umfaßten Blut-(‚clot‘) Kultur, Phagentypisierung Widal-Test, Hämoglobin, weißes Blutbild, Transaminasen, Serumbilirubin, Stuhl- und Urinuntersuchung sowie Stuhl- und Urinkultur. Eine Infektion mit Darmparasiten fand sich bei 42 und mit Shigellen bei 25 Patienten. Die Befunde werden diskutiert und mit den Erfahrungen aus ähnlichen Studien über Typhus abdominalis und Paratyphus verglichen.

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Authors and Affiliations

  1. Kasturba Hospital for Infection Diseases, Bombay, India

    S. A. Kamat

  2. Department of Paediatrics Royal Devon and Exeter Hospital, Exeter, England

    C. Herzog

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  1. S. A. Kamat
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  2. C. Herzog
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Kamat, S.A., Herzog, C. Typhoid: Clinical picture and response to chloramphenicol. Infection 5, 85–91 (1977). https://doi.org/10.1007/BF01642086

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