Fatal complications of acute enteric fevers

ABSTRACT

Eighty eight patients presenting with fatal typhoid complications were studied in Abbassia and Embaba fever hospitals during a 4 years period [1987 - 1991]. Criterion of inclusion in the study was either positive. blood culture in 70 [80%] cases or postmortem gross appearance of typhoid fever in 18 [20%] cases. Positive blood culture cases included 54 [77%] S. typhi and 16 [23%] S. paratyphi A. Seven [10%] cases were resistant in vitro to chloramphenicol. Postmortem examination performed in 18 [20%].cases revealed typical typhoid ulcers in ileum, jejunum and large intestine. The main clinical picture of 31 toxic, 22 encephalitic or meningeal irritating, 15 gastroenteritic, 9 pneumonic, 8 perforated and 3 haemorrhagic enteric fever cases were discussed. The tetrad of fever, toxic look, bronchitic Chest, tumid tympanitic abdomen and splenomegaly was a good sign for suggestion of typhoid diagnosis