ABSTRACT
Objectives: We sought to describe the epidemiological and clinical features of typhoid fever in Qatar
Methods: We conducted a retrospective study of adult patients treated for typhoid fever at Hamad General Hospital and Alkhor Hospital between 2005 and 2012
Results: The mean age of the 354 patients enrolled in the study was 28.4+/-9.3 years; 296 [83.6%] were males. There were 42, 48, 39, 44, 46, 47, 52, and 36 cases of adults with typhoid fever in 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012, respectively. Overall, 343 [96.9%] patients had a history of travel to endemic areas. Among them, 93.0% acquired typhoid fever in the Indian subcontinent. Fever was observed in all cases, and the other predominant symptoms were abdominal pain [38.1%], diarrhea [35.6%], and headache [33.1%]. Salmonella typhi, showed high resistance to ciprofloxacin [n = 163; 46.0%], and low resistance to ceftriaxone [n = 2; 0.6%]. Four patients developed intestinal perforation, which was surgically repaired in two cases. Two patients [0.6%] died
Conclusions: Typhoid fever was frequent among immigrants to endemic areas. Travelers returning from endemic areas with suspected typhoid fever should be treated empirically with third-generation cephalosporin after obtaining appropriate cultures. Moreover, preventive measurements such as education on food and water hygiene, and effective vaccination of travelers should be practiced widely among travelers to endemic areas to reduce morbidity and mortality
ABSTRACT
Rupture of the spleen in malaria may constitute a diagnostic challenge to many clinicians particularly in non-endemic areas where experience with malaria is limited. Our aim is to increase the awareness among clinicians from non-endemic areas of serious malarial complications. We present a young American military man who was admitted to Hamad General Hospital and had 2 serious malarial complications, namely, acute pulmonary edema and rupture of the spleen. He was unusual compared with what was published previously in 4 main points: 1. The rupture of spleen occurred while the patient on mechanical ventilation and under the effect of sedation, which constituted a diagnostic challenge. 2. The 2 complications occurred in a patient with a low parasitemia. 3. The causative species for splenic rupture is Plasmodium falciparum, and 4. The first sample of peripheral blood smear for malarial parasite was negative. We treated him successfully and discharged home in a good condition