Infectious diseases presenting by fever and hepatomegaly

The present study included 51 patients presenting by infectious fever and hepatomegaly. They were admitted to Abbassia and Embaba Fever Hospitals. Patients were subjected to careful history, thorough clinical examination, complete blood picture, urine and stool examination, repeated blood, urine and stool cultures during fever spikes. Slide and tube agglutination test for typhoid and brucella fevers. Mononucleosis diseases were diagnosed by Monospot test, Epstein Barr IgM and G, Cytomegalovirus IgM and G and Toxoplasmosis by indirect fluorescent test. Abdominal U.S., C.T scan and bone marrow examination whenever needed. Fifty one cases included 31[61%] bacterial cases, 12 [23%] mononucleosis cases and 8 [16%] parasitic cases. Thirty one bacterial group included 11[35%] brucella cases, 7 [23%] extrapulmonary tuberculosis, 5 [16%] urinary tract infection, 4 [13%] gram negative septicaemia and 4 [13%] deep seated abscesses. Twelve cases of mononucleosis cases included 6 [50%] infectious mononucleosis, 4 [33%] cytomegalovirus and 2 [17%] toxoplasmosis cases. Eight cases of parasitological group included 4 [50%] malaria cases, 2 [25%] fasciola cases, 1 [12.5%] amoebic liver abscess and 1 [12.5%] due to kala azar. Two [4%] cases died in our series; 1 due to gram negative septicaemia and the other due to kala azar. Cases are discussed and interpreted

Multidrug resistant typhoid fever in Egypt

Typhoid fever is a global health problem, with an estimated 20 million cases and 700.000 deaths annually. In Egypt, since the beginning of the 1980s, there has been an increase prevalence of multidrug resistance to the first line antimirobials, such as chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole [TMP-SMX], shifting the drug of choice for the treatment of typhoid fever to fl uoroquinolones and third generation cephalosporins. Was to detect if multidrug resistant [MDR] typhoid fever is still a problem in Egypt after two decades of its widespread. Also, we studied if resistance had appeared to quinolones and third generation cephalosporins which were widely used for treatment of typhoid fever in the last fi fteen years. In the period between March 2006 and March 2007, thirty seven patients with positive blood culture for Salmonella typhi were included in this study. They were 23 [62%] males and 14 [38%] females with age range from 3 to 45 years [mean 19 +/- 8.2 years]. Drug sensitivity tests showed that 34 [92%] of Salmonella typhi isolates were sensitive to chloramphenicol and 24 [65%] and 23 [62%] isolates were sensitive to ampicillin and TMPSMX, respectively. Only one [3%] isolate was MDR to chloramphenicol, ampicillin and TMP-SMX. All isolates were sensitive to ciprofl oxacin and ceftriaxone. Forteen [38%] patients were treated with chloramphenicol and twenty three [62%] patients were treated with ceftriaxone. All patients were cured. The mean time of defervescence for ceftriaxone and chloramphenicol was 3.7 +/- 1.2 and 5.8 +/- 1.2, respectively. Ceftriaxone was signifi cantly associated with a shorter time of defervescence compared with chloramphenicol. There is marked reduction of prevalence of MDR Salmonella typhi isolates and marked increase of susceptibility of these isolates to chloramphenicol, returning it to be one of the drugs of choice for treatment of acute typhoid fever. No drug resistance to ceftriaxone and ciprofloxacin was reported after many years of using for treatment of acute typhoid fever. Ceftriaxone was significantly associated with short time of defervescence making it the drug of choice for treatment of severe and complicated cases of typhoid fever. Due to high degree of resistance to ampicillin and TMP-SMX they should not be used as first line drugs for treatment of acute typhoid fever

Haemophilus influenzae meningitis at the Abbassia Fever Hospital 1982 to 2001

The aim of this work was to study the prevalence, clinical presentation, outcome of patients with H. influenza meningitis and to determine the efficacy and safety of new therapeutic regimens that could be used in the treatment of the disease and test the susceptibility of the isolates to different antibiotics. During the period from January 1982 to December 2001, 472 children with H. influenza meningitis were admitted to El-Abbassia Fever Hospital, Meningitis Ward in Cairo. The study indicated that H. influenzae is the main causative organism in Egypt accompanied high morality and morbidity rates. Although there has been no increase in the number of cases over the year, a steady increase in the resistance to the traditional drugs has occurred. Thus, it was recommended to use third generation cephalosporins for treatment and Hib vaccines in children

Evaluation of slide agglutination and widal agglutination tests in the diagnosis of acute enteric fever in Cairo

This study we compared the sensitivity, specificity, positive predictive and negative predictive values of Widal tube agglutination test and slide agglutination test, which was used in many fever hospitals for diagnosis of acute typhoid fever because of its simplicity and cheapness. This study included 25 normal controls, 153 diseased control patients [non-typhoidal] and 36 acute typhoid fever patients. The sensitivity, specificity, positive and negative predictive values for Widal tube agglutination test were 91.7%, 100% and 98% and for slide agglutination test were 86%, 83%, 55.4% and 97.7%, respectively. It was concluded from this study that Widal agglutination test is a valid test for diagnosis of acute typhoid fever in Egypt and that slide agglutination test is a rough screening test for suspected typhoid diagnosis which is valuable for exclusion and not for diagnosis