Skip to main content
Top
Published in: International Journal of Emergency Medicine 1/2010

Open Access 01-03-2010 | Original Research Article

Diagnosis of enteric fever in the emergency department: a retrospective study from Pakistan

Authors: Uzma Rahim Khan, Junaid A. Razzak, Ali Faisal Saleem, Adnan Ahmed, Sabeena Jalal

Published in: International Journal of Emergency Medicine | Issue 1/2010

Login to get access

Abstract

Background

Enteric fever is one of the top differential diagnoses of fever in many parts of the world. Generally, the diagnosis is suspected and treatment is initiated based on clinical and basic laboratory parameters.

Aims

The present study identifies the clinical and laboratory parameters predicting enteric fever in patients visiting the emergency department of a tertiary care hospital in Pakistan.

Methods

This is a retrospective chart review of all adult patients with clinically suspected enteric fever admitted to the hospital through the emergency department during a 5-year period (2000–2005).

Results

A total of 421 emergency department patients were admitted to the hospital with suspected enteric fever. There were 53 cases of blood culture-positive enteric fever and 296 disease-negative cases on culture. The mean age in the blood culture-positive group was 27 years (SD: 10) and in the group with negative blood culture for enteric fever, 35 years (SD: 15) with a male to female ratio of 1:0.6 in both groups. Less than half (48%) of all patients admitted with suspected enteric fever had the discharge diagnosis of enteric fever, of which only 13% of the patients had blood culture/serologically confirmed enteric fever. None of the common clinical and laboratory parameters differed between enteric fever-positive patients and those without it.

Conclusion

Commonly cited clinical and laboratory parameters were not able to predict enteric fever.
Literature
1.
go back to reference WHO (2008) Enteric fever. In: Guidelines on standard operating procedures for microbiology. WHO Regional Office for South-East Asia, Geneva, Switzerland WHO (2008) Enteric fever. In: Guidelines on standard operating procedures for microbiology. WHO Regional Office for South-East Asia, Geneva, Switzerland
2.
go back to reference González A, Malo Q, Román Muñoz J, Molina J, Pérez MT, Domínguez J, Bisquert J (1994) Microbiologic diagnosis of typhoid fever: report on an outbreak (in Spanish). Enferm Infecc Microbiol Clin 12:372–377PubMed González A, Malo Q, Román Muñoz J, Molina J, Pérez MT, Domínguez J, Bisquert J (1994) Microbiologic diagnosis of typhoid fever: report on an outbreak (in Spanish). Enferm Infecc Microbiol Clin 12:372–377PubMed
5.
go back to reference CDC (2007) Prevention of specific infectious diseases: typhoid fever, Chap. 4. In: Arguin PM, Kozarsky PE, Reed C (eds) CDC health information for international travel 2008. Elsevier, Atlanta CDC (2007) Prevention of specific infectious diseases: typhoid fever, Chap. 4. In: Arguin PM, Kozarsky PE, Reed C (eds) CDC health information for international travel 2008. Elsevier, Atlanta
7.
go back to reference Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ (2002) Typhoid fever. N Engl J Med 347:1770–1782PubMedCrossRef Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ (2002) Typhoid fever. N Engl J Med 347:1770–1782PubMedCrossRef
8.
go back to reference Vollaard AM, Ali S, Widjaja S, Asten HA, Visser LG, Surjadi C, van Dissel JT (2005) Identification of typhoid fever and paratyphoid fever cases at presentation in outpatient clinics in Jakarta, Indonesia. Trans R Soc Trop Med Hyg 99:440–450PubMedCrossRef Vollaard AM, Ali S, Widjaja S, Asten HA, Visser LG, Surjadi C, van Dissel JT (2005) Identification of typhoid fever and paratyphoid fever cases at presentation in outpatient clinics in Jakarta, Indonesia. Trans R Soc Trop Med Hyg 99:440–450PubMedCrossRef
9.
go back to reference Neopane APM, Pradhan B, Dhakal R, Karki DB (2006) Enteric fever: diagnostic value of clinical features. Kathmandu Univ Med J 4:307–315 Neopane APM, Pradhan B, Dhakal R, Karki DB (2006) Enteric fever: diagnostic value of clinical features. Kathmandu Univ Med J 4:307–315
10.
go back to reference Nazar HS, Rabbani A, Riaz A, Anwar J (2005) Presentation of typhoid fever patients in Hazara Division and response to different treatment regimens. J Ayub Med Coll Abbottabad 17:67–69PubMed Nazar HS, Rabbani A, Riaz A, Anwar J (2005) Presentation of typhoid fever patients in Hazara Division and response to different treatment regimens. J Ayub Med Coll Abbottabad 17:67–69PubMed
11.
go back to reference Gendron Y, Thevenieau D, Touze JE, Mailloux C, Barabe P (1981) Typhoid fever in adult patients in Ouagadougou (analytic study of 124 cases) (in French). Med Trop (Mars) 41:625–631 Gendron Y, Thevenieau D, Touze JE, Mailloux C, Barabe P (1981) Typhoid fever in adult patients in Ouagadougou (analytic study of 124 cases) (in French). Med Trop (Mars) 41:625–631
12.
go back to reference Ross IN, Abraham T (1987) Predicting enteric fever without bacteriological culture results. Trans R Soc Trop Med Hyg 81:374–377PubMedCrossRef Ross IN, Abraham T (1987) Predicting enteric fever without bacteriological culture results. Trans R Soc Trop Med Hyg 81:374–377PubMedCrossRef
13.
go back to reference Khan M, Coovadia YM, Connoly C, Sturm AW (1998) The early diagnosis of typhoid fever prior to the Widal test and bacteriological culture results. Acta Trop 69:165–173PubMedCrossRef Khan M, Coovadia YM, Connoly C, Sturm AW (1998) The early diagnosis of typhoid fever prior to the Widal test and bacteriological culture results. Acta Trop 69:165–173PubMedCrossRef
14.
go back to reference Mathura KC, Gurubacharya DL, Shrestha A, Pant S, Basnet P, Karki DB (2003) Clinical profile of typhoid patients. Kathmandu Univ Med J 1:135–137 Mathura KC, Gurubacharya DL, Shrestha A, Pant S, Basnet P, Karki DB (2003) Clinical profile of typhoid patients. Kathmandu Univ Med J 1:135–137
15.
go back to reference Tohme A, Zein E, Nasnas R (2004) Typhoid fever. Clinical and therapeutic study in 70 patients (in French). J Med Liban 52:71–77PubMed Tohme A, Zein E, Nasnas R (2004) Typhoid fever. Clinical and therapeutic study in 70 patients (in French). J Med Liban 52:71–77PubMed
16.
go back to reference Su CP, Chen YC, Chang SC (2004) Changing characteristics of typhoid fever in Taiwan. J Microbiol Immunol Infect 37:109–114PubMed Su CP, Chen YC, Chang SC (2004) Changing characteristics of typhoid fever in Taiwan. J Microbiol Immunol Infect 37:109–114PubMed
17.
go back to reference Lefebvre N, Gning SB, Nabeth P, Ka S, Ba-Fall K, Rique M, Sane M, Chevalier B, Mbaye PS, Debonne JM (2005) Clinical and laboratory features of typhoid fever in Senegal. A 70-case study (in French). Med Trop (Mars) 65:543–548 Lefebvre N, Gning SB, Nabeth P, Ka S, Ba-Fall K, Rique M, Sane M, Chevalier B, Mbaye PS, Debonne JM (2005) Clinical and laboratory features of typhoid fever in Senegal. A 70-case study (in French). Med Trop (Mars) 65:543–548
18.
go back to reference Haq SA, Alam MN, Hossain SM, Ahmed T, Tahir M (1997) Value of clinical features in the diagnosis of enteric fever. Bangladesh Med Res Counc Bull 23:42–46PubMed Haq SA, Alam MN, Hossain SM, Ahmed T, Tahir M (1997) Value of clinical features in the diagnosis of enteric fever. Bangladesh Med Res Counc Bull 23:42–46PubMed
19.
go back to reference Hosoglu S, Celen MK, Geyik MF, Akalin S, Ayaz C, Acemoglu H, Loeb M (2006) Risk factors for typhoid fever among adult patients in Diyarbakir, Turkey. Epidemiol Infect 134:612–616PubMedPubMedCentralCrossRef Hosoglu S, Celen MK, Geyik MF, Akalin S, Ayaz C, Acemoglu H, Loeb M (2006) Risk factors for typhoid fever among adult patients in Diyarbakir, Turkey. Epidemiol Infect 134:612–616PubMedPubMedCentralCrossRef
Metadata
Title
Diagnosis of enteric fever in the emergency department: a retrospective study from Pakistan
Authors
Uzma Rahim Khan
Junaid A. Razzak
Ali Faisal Saleem
Adnan Ahmed
Sabeena Jalal
Publication date
01-03-2010
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Emergency Medicine / Issue 1/2010
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1007/s12245-009-0146-3

Other articles of this Issue 1/2010

International Journal of Emergency Medicine 1/2010 Go to the issue