[Typhoid fever. Clinical and therapeutic study in 70 patients].
OBJECTIVE
Present clinical features of typhoid fever in Lebanon.


METHODS
Retrospective study of 70 patients admitted to a university hospital center between 1995 and 2002. The criteria for inclusion were a positive Salmonella typhi or paratyphi hemoculture and/or a Widal serodiagnosis > or = 1/160 for O agglutinin, in the presence of evocative symptoms.


RESULTS
Among the 70 patients, 25 pediatric cases were noted. The patients were aged a mean of 28+/-22 years. Average duration of symptoms before the diagnosis was 10+/-7 days. Fever were observed in 97% of cases and the other predominant symptoms were abdominal pain (41%), diarrhoea (36%), chills (31%) and headache (29%). Febrile gastroenteritis was a frequent manifestation in children (52%). Complications were noted in 31% of cases and were predominantly digestive. Leucopenia was not a helpful diagnostic marker. S. typhi was the most frequent (87%) serotype identified. Resistance to ampicilline was 10%, to cotrimoxazole and chloramphenicol 7% for each and to ofloxacine 2%. One death was reported (1%) of an immunosuppressed patient.


CONCLUSIONS
Typhoid fever is still an endemic disease in Lebanon and should be systematically evoked in the case of prolonged fever, febrile gastroenteritis and/or headache. The appearance of bacteria resistant to antibiotics makes ceftriaxone or ciprofloxacine the empirical treatment of choice.
Tohme
Aline
A
Service de Médecine interne et maladies infectieuses, Hôtel-Dieu de France-Beyrouth, Faculté de médecine, Université Saint-Joseph, Beyrouth. atohme2@inco.com.lb
Zein
Emile
E
Nasnas
Roy
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D006801:Humans; D007223:Infant; D007861:Lebanon / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012621:Seasons; D013997:Time Factors; D014435:Typhoid Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D000900:Anti-Bacterial Agents