Typhoid and paratyphoid fever: A 10-year retrospective study of 41 cases in a Parisian hospital
Typhoid and paratyphoid fever: A 10-year retrospective study of 41 cases in a Parisian hospital
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DOI：
10.2310/7060.2001.22378
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发表时间：
2001-11-01
影响因子：
25.7
通讯作者：
Bricaire, F
中科院分区：
文献类型：
--
作者：
Caumes, E;Ehya, N;Bricaire, F
背景：肠道热仍然是旅行者发热的主要原因。我们评估了新的趋势，在肠道fester.Methods：我们回顾了流行病学，临床，生物学，细菌学数据，和结果的所有病例的伤寒和副伤寒在我们的部门看到在过去的十年。纳入标准是存在的迹象兼容伤寒沙门氏菌或甲型副伤寒沙门氏菌，B，或C从血液或粪便培养或任何其他site.Results：在41例患者中，38（93%）有旅行相关的肠热病。污染的主要地理来源是印度次大陆。1例患者在1年前接种了胃肠外Vi疫苗。发烧和头痛是80%以上患者的唯一症状。入选时肥达试验阳性率为27%，第二次血清学试验阳性率为50%。血培养阳性34例，粪培养阳性10例。4例患者的血培养和粪便培养均分离出沙门氏菌，1例患者的尿液中分离出沙门氏菌。两株S.伤寒杆菌对氨苄青霉素、氯霉素和复方新诺明耐药。一株S.伤寒沙门氏菌1株; B型副伤寒对萘啶酸耐药。除2例患者（1例失败，1例复发）外，所有可评价患者均治愈。我们观察到3种毒性反应。结论：肠热病的临床和生物学表现缺乏特异性，耐药率增高，治疗过程中毒性反应的发生，严重影响了肠热病的诊断和转归。
Background: Enteric fever remains a major cause of fever in travelers. We evaluated new trends in enteric fever.Methods:We reviewed the epidemiological, clinical, biological, bacteriological data, and outcome of all cases of typhoid and paratyphoid fever seen in our department over the last decade. The inclusion criteria were the presence of signs compatible with enteric fever and isolation of Salmonella typhi or Salmonella paratyphi A, B, or C from blood or stool cultures or any other site.Results: Among the 41 patients, 38 (93%) had travel-associated enteric fever. The main geographic source of contamination was the Indian subcontinent. One patient had been vaccinated with parenteral Vi vaccine 1 year previously. Fever and headaches were the only signs which were present in more than 80% of patients. The Widal test at inclusion was positive in 27%, and a second serological test was found to be positive in 50% of evaluated cases. Blood cultures and stool cultures were positive in 34 cases and 10 cases, respectively. Salmonellae spp were isolated in both hemocultures and stool cultures in 4 cases and in urine in 1 case. Two strains of S. typhi were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. One strain of S. typhi and one of S. paratyphi B were nalidixic acid resistant. All evaluable patients were cured with the exception of 2 patients (1 failure, 1 relapse). We observed 3 toxic reactions. No patients died.Conclusion:The diagnosis and outcome of enteric fever are hampered by the lack of specificity of clinical and biological signs, the increasing rates of antimicrobial resistance, and the occurrence of toxic reactions during treatment.