Mansoor Nadeem, Nadir Ali, Humaira Achkzai, Ishtiaq Ahmed.
A profile of Enteric fever in adults at Quetta.
Pak J Pathol Jan ;13(2):12-7.

Ninety two adult patients suffering from culture proven Enteric fever comprising of typhoid fever (70) and Paratyphoid fever (22) were studied in regards to clinical presentation laboratory finding, complications and response to treatment in special reference to patients feeling of well being/defervescence after treatment with ciprofloxacin. Fever with rigors and chills were noted in 47% patients. Headache was present in 95% of cases, myalgia body in 88%; vomiting in 28%, cough in 31%, loose bowel movements in 12%. Relative bradycardia in 81%, Splenomegaly in 43%, Hepatomegaly in 22% were the significant clinical signs. Rose spots were not observed in any case. Leucopenia was noted in 27% of cases, thrombocytopenia in 15%, widal titers were significantly raised in 26% of the patients. None of our patients had life threatening complications. However, 24% had mild hepatotoxicity. None of the cases had signs of pneumonitis or evidence of myocarditis depicted by ECG changes or increased serum cardiac enzymes. None of the Salmonella Typhi & Salmonella Paratyphi A was found resistant to ciprofloxacin. Feeling of wellbeing was noted from 2-7 days and defervescence was noted from 4-9 days. Ninety three percent of our patients were already vaccinated with the heat killed phenol extracted. The whole typhoid vaccine proved to be of extremely poor protective value.

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