Clinical profile of typhoid fever in children at a tertiary care hospital: a cross sectional study

Authors

  • Siddiqui S. S. Department of Pediatrics, MGM Medical College, Aurangabad, Maharashtra, India
  • Shivraj Kumar Koppa Department of Pediatrics, MGM Medical College, Aurangabad, Maharashtra, India
  • Kale A. V. Department of Pediatrics, MGM Medical College, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20174192

Keywords:

Enteric fever, Splenomegaly, Toxic look

Abstract

Background: In endemic areas such as India, traditional signs and symptoms in enteric fever are not often observed. Unusual presentations lead to diagnostic dilemma and may delay the diagnosis of typhoid fever. The present study describes the clinical presentation of enteric fever at a tertiary care centre in Aurangabad district of Maharashtra.

Methods: The study was a hospital based prospective observational study done in paediatric ward of MGM Medical College, Aurangabad over a period of 18 month starting from 1st November 2013 to 31st April 2015. The parents of the children were informed about the research and its objectives, and written informed consent was obtained from them. Prior approval was taken from institutional ethics committee.  Children of age 2 -18 years who presented with fever of 5 days or more with clinical signs and symptoms suggestive of typhoid fever and positive Widal test or Typhidot tests were included in the study. The demographic and clinical features of the patients were described.

Results: Total of 99 patients were included in the study. Majority of the children were between 2 - 7 year age group (45.4%). Out of 99 children, 57 were males and 42 were females. Majority of the cases were from urban areas accounting for 75%, which included urban slums. Drinking water source was tap water in 80% cases and bore well water in 20% cases. Only 36.4% of children had fever of less than one-week duration. 58.6% of the cases had fever of more than one week but less than two weeks. Continuous fever was noticed in majority of children (55.55%). All the children presented with fever as the main complaint (100%). Loss of appetite and headache were the next common complaints reported by 59.6% cases. Commonest sign noticed was toxic look (83.8%) followed by coated tongue (74.7%) and splenomegaly (61.6%). Hepatomegaly was also noted in 39.4% of cases.

Conclusions: Clinical presentation in the study subjects was similar to available reports from literature.

References

Ivanoff B. Typhoid fever, global situation and WHO recommendations. Southeast Asian J Trop Med Public Health.1995;26supp 2:1-6.

Ivanoff B, Levine MM, Lambert PH. Vaccination against typhoid fever: present status. Bull World Health Organ. 1994;72(6):957-71.

Kothari A, Pruthi A, Chugh TD. The burden of enteric fever. J Infect Dev Ctries. 2008;2(4):253-9.

Garg RA, Krashak R. Typhoid fever before two years of age. Indian Pediatr. 1993;30(6):805-8.

Sen S, Goyal RS, Dev R. Ciprofloxacin in the management of multiple drug resistant typhoid fever. Indian Pediatr. 1991;28(4):417-9.

Comeau JL, Tran TH, Moore DL, Phi CM, Quach C. Salmonella enterica serotype typhi infections in a Canadian pediatric hospital: a retrospective case series. CMAJ Open. 2013;1(1):E56-61.

Modi R. Clinical profile and treatment outcome of typhoid fever in children at a teaching hospital, Ahmedabad, Gujarat, India. Int J Med Sci Public Health. 2016;5:212-6.

Devaranavadagi RA, Srinivasa S. A study on clinical profile of typhoid fever in children. Int J Contemp Pediatr. 2017;4:1067-73.

Sinha A, Sazawal S, Kumar R, Sood S, Singh B, Reddaiah VP et al. Typhoid fever in children aged less than 5 years. Lancet. 1999;354:734-7.

Kapoor JP, Mohan M, Talwar V, Daral TS, Bhargava SK. Typhoid fever in young children. Indian Pediatr. 1985;22:811-3.

Joshi BG, Keyal K, Pandey R, Shrestha BM. Clinical profile and sensitivity pattern of Salmonella serotypes in children: a hospital based study. J Nepal Pediatr Soc. 2011;31(3):180-3.

Laishram N, Singh PA. Clinical profile of enteric fever in children. J Evol Med Dent Sci. 2016;5(2):114-6.

Ganesh R, Janakiraman L, Vasanthi T, Sathiyasekeran M. Profile of typhoid fever in children from a tertiary care hospital in Chennai-South India. Indian J Pediatr. 2010;77(10):1089-92.

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Published

2017-10-24

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Original Research Articles