Aim To study the clinical profile and outcome of typhoid fever in children from a tertiary care hospital in Chennai, South India.
Subjects and Methods Retrospective study from Kanchi Kamakoti Childs Trust Hospital case records of children aged 1 month to 18 years with typhoid fever (blood culture positive for Salmonella typhi) during the period January–December 2007 were analysed for clinical features, laboratory parameters, treatment and follow-up details
Result During this period, 100 children had typhoid fever out of 13 265 admissions. The male : female ratio was 2 : 1. The majority (51%) of children were below 5 years, 32% were between 5 and 10 years and 17% were above 10 years. Clustering of cases was seen between the months September and December. Predominant symptoms were fever in 100%, vomiting (54%) and loose stools (31%). Common clinical signs observed: hepatomegaly (72%), splenomegaly (31%), coated tongue (24%). Eosinopaenia was observed in 67%. None had sonographic evidence of cholelithiasis. Ceftriaxone was the commonly prescribed antibiotic and duration of treatment ranged from 10 to 14 days. Nalidixic acid-resistant S typhi was seen in 56%. The mean duration of hospitalisation was 6.94 days. Two children had a relapse, three had septic shock and one had haemophagocytosis. There was no mortality.
Conclusion Our study describes only the tip of the iceberg (we excluded serological evidence of typhoid fever). The majority of cases was seen in children under 5 years. Eosinopaenia was the most common haematological parameter observed. Nalidixic acid-resistant S typhi is on a rising trend. Reinforcement of health education and personal hygiene will help to reduce this disease burden in developing countries.
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