Publication

Abstract : Background: Typhoid fever requires prompt diagnosis to avoid serious morbidity and mortality. Early diagnosis is still a challenge in developing countries and the clinical picture is not specific, leading to use of empiric antibiotic therapy.Methodology: A retrospective study of culture proven cases of typhoid fever carried-out at a 600 bed teaching hospital in Delhi, India. The records of patients (age > 10 years) with a diagnosis of typhoid fever discharged from the Department of Medicine, between January 2012 and December 2012 were evaluated.Results: A total of 88 patients were included. There was decreasing number of cases, with increasing age. The most common symptoms were headache, abdominal pain, loose stools and vomiting, and signs hepatosplenomegaly, only hepatomegaly, only splenomegaly. The lab findings were nonspecific. Typhidot test had low sensitivity. There was no significant difference in the mean time to defervescence in those with or without prior antibiotic therapy. Antibiotic treatment with combination of ceftriaxone and azithromycin was not superior to treatment with ceftriaxone alone.Conclusion: Clinical features of typhoid fever were similar in our study to previous studies; however, non were sensitive or specific enough to enable a clinical diagnosis of typhoid fever. There is still need to find a sensitive and specific rapid test for reliable diagnosis of typhoid fever. Ceftriaxone is the cornerstone of antibiotic therapy for typhoid fever and adding azithromycin does not improve the outcome but adds to the cost of therapy.