[Typhoid fever. Retrospective study of 52 cases in Lebanon].
OBJECTIVE
Present the epidemiology and clinical characteristics of typhoid fever in the Lebanon.


METHODS
Retrospective study of 52 patients admitted to a university hospital center between 1995 and 1999. The criteria for inclusion were a positive Salmonella typhi or paratyphi hemoculture and/or Widal serodiagnosis > 1/160 for O agglutinin, in the presence of evocative symptoms.


RESULTS
The patients were aged a mean of 31 +/- 24 years. The mean duration between the onset of fever and diagnosis was of 10 +/- 8 days. Fever was observed in 96% of cases and the other predominant symptoms were diarrhea (37%), abdominal pain (31%) and headache (29%). Feverish gastroenteritis is a frequent manifestation in children (61% of cases). Complications were noted in 33% of cases and were predominantly digestive. Leukopenia is not a good diagnostic marker. S. typhi was the cause in 83% of cases. Resistance to ampicillin was noted in 13% of cases, to cotrimoxazole and to chloramphenicol in 10% and to ofloxacine in 3% of cases. One death was reported (2%) of an immunodepressed patient.


CONCLUSIONS
Typhoid fever is still an endemic disease in the Lebanon and should be systematically evoked in the case of prolonged fever, feverish gastroenteritis and/or headache. The appearance of bacteria resistant to antibiotics makes ceftriaxone or ciprofloxacine the empirical treatment of choice.
Tohmé
Aline
A
Service de médecine interne, Hôtel-Dieu de France Université Saint-Joseph, Faculté de médecine, Beyrouth, Liban. atohme2@inco.com.lb
Abboud
Johny
J
el-Murr
Tony
T
Ghayad
Elie
E
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000668:Ampicillin Resistance; D002511:Cephalosporins / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000209:etiology; D005759:Gastroenteritis / Q000209:etiology; D006261:Headache / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012698:Serologic Tests; D012720:Severity of Illness Index; D014435:Typhoid Fever / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology
D002511:Cephalosporins