Typhoid fever in Hong Kong children.
Experience with typhoid fever in 111 children over a 5-year period was reviewed. There were 66 boys and 45 girls, ranging in age from 1 to 11.5 years. The symptoms of typhoid fever were quite non-specific. Fever was the most common presenting symptom (in 98.3%). Other common presenting features were diarrhoea (25.7%), constipation (22%), vomiting (21.1%), cough (25%), abdominal pain (27.5%), headache (9.2%), epistaxis, meningism and convulsions. Rose spots were detected in 20% of cases, occurring mainly during the first 2 weeks of illness. Significant Widal reactions were present in 84.7% of cases. Blood and stool cultures were positive in 57% and 44% of cases, respectively. Peripheral blood white cell counts were not found to be of great diagnostic value. Chloramphenicol remained the drug of choice in the treatment of typhoid fever. It was more effective than ampicillin or co-trimoxazole. Complications were uncommon, occurring in only two patients. There were two deaths; both were admitted late and in moribund state. Early diagnosis and treatment is vital in typhoid fever and, as the presenting features are non-specific, a high index of suspicion is required.
Chow
C B
CB
Paediatric A Unit, Princess Margaret Hospital, Hong Kong.
Wang
P S
PS
Leung
N K
NK
D000667:Ampicillin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000627:therapeutic use; D004338:Drug Combinations / Q000627:therapeutic use; D005260:Female; D006723:Hong Kong; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014435:Typhoid Fever / Q000175:diagnosis* / Q000188:drug therapy
D000890:Anti-Infective Agents; D004338:Drug Combinations; D002701:Chloramphenicol; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole