Re-birth of typhoid fever in Catalonia in the XXIst century. Comments on its clinical presentation and treatment

Antoni Martínez-Roig, Immaculada Morales, Ruben Berrueco, Adela Retana, Anna Fernàndez-López, Albana Puig-Palau, Neus Pociello, Maria Alba Gairí, Teresa Vallmanya, Zaira Ibars, Maria Bonet-Alcaina, Antoni Robert Gomà

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Background. Typhoid fever was very prevalent in Catalonia until the 1980s, but its incidence has declined in the past decades. Thus, pediatricians are not experienced in the diagnosis and treatment of this disease. Objectives. To review the cases of typhoid fever diagnosed at our institutions in recent years, and to discuss the most relevant aspects of the disease. Methods. Retrospective review of the cases diagnosed between 2002 and 2006, including demographic, epidemiological, clinical and laboratory characteristics, as well as treatment and outcome. Results. Ten cases of typhoid fever were diagnosed between 2002 and 2006. Two cases occurred in native children and 8 cases occurred in foreign children, 7 of whom had arrived in Catalonia 2 to 15 days prior to diagnosis. Fever was the only presenting symptom in all cases and its duration was 3 to 15 days. The diagnosis was with blood culture in all cases. Two cases showed antibiotic resistances. Treatment included intravenous or oral 3rd generation cephalosporins in 8 cases, amoxicillin-clavulanate in 1 case, and azythromycin in 1 case. Temperature normalized at a median of 6.3 days (range 3-15 days). Complications included 4 cases of hepatitis, 3 cases of cholecystitis, and one case each of coagulopathy, anemia (whoch required transfusion), and pancreatitis. All complocations resolved uneventfully. Once case recurred 15 days later. Conclusions. a) None of the cases were diagnosed by clinical suspicion; b) Ultrasonography is very helpful in the follow-up of the possible abdominal complications; c) Updates in treatment are discussed.
Idioma originalEnglish
Pàgines (de-a)12-18
RevistaPediatria Catalana
Volum68
Número1
Estat de la publicacióPublicada - 1 de gen. 2008

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