Aims Enteric fever is endemic in India and its diagnosis in early stages is a clinician nightmare. Our aim was to study the clinical profile, haematological features, antimicrobial susceptibility pattern of the isolates, time to defervescence with the treatment received of culture proven typhoid cases.
Material and methods This was a retrospective chart review of 154 cases of culture proven enteric fever carried out at a tertiary care private hospital in Gurgaon over the period January 2010 to December 2013.
Results All patient enrolled were culture positive 78% of the isolates were Salmonella typhi while 22% were Salmonella paratyphi A. Clinical feature of dry parched lips and coated tongue was seen in 100% patient and abdominal symptoms in 70% patient. Enteric fever was seen in younger age group and infancy in 15% patient. An absolute eosinopenia was seen in 81.8% of the patients. Before being admitted to the hospital, 24.6% received antibiotics. The mean time to defervescence in patients who received prior antibiotics was 3.4 days while that in those who did not receive prior antibiotics was 5.1 days. Severe complication rate was less than 1%.
Conclusions A high culture positivity despite prior or ongoing antibiotic treatment was seen. Absolute eosinophil count and high acute phase reactant in early stage could be an important marker of typhoid. High prevalence of resistance to fluoroquinolones was observed. Early defervescence was seen in patient with combination treatment in comparison to single antibiotic.