Clinical Profile of Enteric Fever and Response to Ceftriaxone

Abstract

Background: Enteric fever mimics other febrile illnesses. Third generation cephalosporin are increasingly popular in the treatment of typhoid fever because of resistance to previously used first line drugs. Hence, this study was undertaken to evaluate clinical and laboratory profile and determine response to ceftriaxone. Method: Retrospective data of sixty-six enteric fever patients with clinical and laboratory diagnosis was included in the study. Only culture proven or widal positive cases of enteric fever were included in the study. Clinical, laboratory and treatment information were extracted from the medical records on a detailed proforma and analysed. Results: Fever was present in all patients. Vomiting and abdominal pain in 42%,Cough 42%, Coated tongue 41%, Hepatomegaly 58%, splenomegaly 33%, Widal test 91%, Blood culture 29% (salmonella typhi 19% and paratyphi 10%) of patients. Average Total leucocyte count (TLC) was 6934/cu.mm and average platelet count was 2 lacs sixty-five thousand. In the present study, 10 patients had leucopenia while 5 patients had leucocytosis. Ceftriaxone was used in all patients. Response to ceftriaxone was 100% in the present study. Response to fever with ceftriaxone was ranged from third day to tenth day with median of sixth day. Discussion and Conclusion: In the recent years, rising incidence of salmonella paratyphi serotype on blood cultures has been observed, owing to selective immunisation against salmonella typhi. However, salmonella typhi is still the primary causative organism for enteric fever. Ceftriaxone has emerged as effective therapy in the treatment of enteric fever in pediatric patients.