Muhammad Fazil.
Clinical manifestations of enteric fever in various age groups of children clinical manifestations of enteric fever in various age groups of children.
Pak Paed J Jan ;36(3):142-5.

Objective: To know the clinical manifestations of enteric fever on the basis of age difference in <5 years and ≥ 5 years old children. Methods: This study was conducted to know the clinical profile of enteric fever patients admitted in pediatric unit of Bacha Khan Medical College/Mardan Medical Complex teaching hospital Mardan from 1st May 2010 to 30th April 2011. A total of 36 patients between the age of 9 months to 12 years with fever with Widal positive and/or with culture grown salmonella were included. Results: Mean age of presentation was 5±3 years. Male to female ratio was 2:1. Common clinical features were fever (100%), vomiting (38.8%), abdominal pain (27.77%), cough (27.77%), diarrhea (19.44%), hepatomegaly (80.55%), splenomegaly (47.22%), relative bradycardia (13.88%) and rose spots (8.33%). None of the patients had constipation. In the age group <5 years, diarrhea was more common, whereas relative bradycardia was seen only in ≥5 years age group. Of all first line antibiotic used, ceftriaxone was used in 31 (86.11%), ciprofloxacin in 4 (11.11%) and cefotaxime in one (2.7%). Failure of first line antibiotic was seen in 30.5% patients. Complications were seen in 6 (16.66%) patients, of which 2 (33.32%) had serositis, 1 (16.67%) each had osteomylitis, synovitis, splenic abscess and shock. 34 (94.44%) children recovered, 1 died and 1 was lost to follow up. Recovery was faster in <5 years age group as compared to ≥5 years old. 30% of our patients had resistance to third generation cephalosporin as first line antibiotics. Conclusion: In the age group <5 years, diarrhea was more common, whereas relative bradycardia was seen only in ≥ 5 years age group. Constipation was not a feature in any case. Clinical features like fever, vomiting, abdominal pain, cough, diarrhea, hepatomegaly, splenomegaly, and rose spots were present in both age groups.

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