Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children
Aim: We aimed to study the clinical profile of enteric fever in children at an urban tertiary care children's hospital in South India. Materials and methods: We carried out a retrospective study of culture-proven enteric fever in children aged 0–18 years between January 2018 and March 2023. We...
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Jaypee Brothers Medical Publisher
2024-03-01
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| Series: | Pediatric Infectious Disease |
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| Online Access: | https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1408 |
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| author | Divya Priyadharshini Mobill Clinton Nandini Sethuraman Mathrubootham Sridhar Vidya Krishna |
| author_facet | Divya Priyadharshini Mobill Clinton Nandini Sethuraman Mathrubootham Sridhar Vidya Krishna |
| author_sort | Divya Priyadharshini |
| collection | DOAJ |
| description | Aim: We aimed to study the clinical profile of enteric fever in children at an urban tertiary care children's hospital in South India.
Materials and methods: We carried out a retrospective study of culture-proven enteric fever in children aged 0–18 years between January 2018 and March 2023. We included 128 children in total; 109 inpatients (85.2%) and 19 outpatients (14.8%).
Results: Enteric fever accounted for 4.9% of nonrespiratory febrile admissions (<i>n</i> = 2,204). A total of 98 (76.5%) had <i>Salmonella typhi (S. typhi)</i>, while 30 (23.5%) had <i>Salmonella paratyphi (S. paratyphi) A</i> in their blood. Leukopenia occurred in 28 (21.8%) patients. The average inpatient fever defervescence time was 4.62 days (range: 1–28 days). A total of 26 children (20.3%) experienced fever defervescence after 5 days. The mean C-reactive protein (CRP) was 58.2 mg/dL in the group with fever defervescence in <5 days and 63.3 mg/dL for >5 days (<i>p</i> = 0.540). Single antibiotic was used in only 25 children (19.5%). Mean fever defervescence time was 4.8 days in the single antibiotic group and 4.5 days in the combination group (<i>p</i> = 0.47), and in typhoid vs paratyphoid, it was 4.8 vs 3.3 days (<i>p</i> = 0.04).
Conclusion: <i>Salmonella paratyphi (S. paratyphi)</i> caused 23.5% of culture-proven enteric fever cases. Most cases had normal leukocyte counts, eosinopenia, and elevated CRP. CRP does not predict fever defervescence. Fever typically resolved in 4–5 days, with paratyphoid fever resolving earlier. Combination therapy was used in over two-thirds of cases.
Clinical significance: <i>Salmonella paratyphi (S. paratyphi)</i> is a significant cause of enteric fever in children. There seems to be no clear benefit for combination therapy from our small retrospective data, but study limitations preclude drawing accurate conclusions. Future areas of research interest will include an effective vaccine for paratyphoid fever and a randomized clinical trial on single vs combination therapy in enteric fever. |
| format | Article |
| id | doaj-art-c3e061948d984db9a1e0a7fa0a8c7efc |
| institution | Kabale University |
| issn | 2582-4988 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Jaypee Brothers Medical Publisher |
| record_format | Article |
| series | Pediatric Infectious Disease |
| spelling | doaj-art-c3e061948d984db9a1e0a7fa0a8c7efc2025-02-07T11:19:55ZengJaypee Brothers Medical PublisherPediatric Infectious Disease2582-49882024-03-01616910.5005/jp-journals-10081-14082Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in ChildrenDivya Priyadharshini0Mobill Clinton1Nandini Sethuraman2Mathrubootham Sridhar3Vidya Krishna4Department of Pediatrics, Apollo Children's Hospital, Chennai, Tamil Nadu, IndiaDepartment of Pediatrics, Apollo Children's Hospital, Chennai, Tamil Nadu, IndiaDepartment of Microbiology, Apollo Hospitals, Chennai, Tamil Nadu, IndiaDepartment of Pediatrics, Apollo Children's Hospital, Chennai, Tamil Nadu, IndiaDepartment of Pediatric Infectious Diseases, Apollo Children's Hospital, Chennai, Tamil Nadu, India, Phone: +91 7845803309Aim: We aimed to study the clinical profile of enteric fever in children at an urban tertiary care children's hospital in South India. Materials and methods: We carried out a retrospective study of culture-proven enteric fever in children aged 0–18 years between January 2018 and March 2023. We included 128 children in total; 109 inpatients (85.2%) and 19 outpatients (14.8%). Results: Enteric fever accounted for 4.9% of nonrespiratory febrile admissions (<i>n</i> = 2,204). A total of 98 (76.5%) had <i>Salmonella typhi (S. typhi)</i>, while 30 (23.5%) had <i>Salmonella paratyphi (S. paratyphi) A</i> in their blood. Leukopenia occurred in 28 (21.8%) patients. The average inpatient fever defervescence time was 4.62 days (range: 1–28 days). A total of 26 children (20.3%) experienced fever defervescence after 5 days. The mean C-reactive protein (CRP) was 58.2 mg/dL in the group with fever defervescence in <5 days and 63.3 mg/dL for >5 days (<i>p</i> = 0.540). Single antibiotic was used in only 25 children (19.5%). Mean fever defervescence time was 4.8 days in the single antibiotic group and 4.5 days in the combination group (<i>p</i> = 0.47), and in typhoid vs paratyphoid, it was 4.8 vs 3.3 days (<i>p</i> = 0.04). Conclusion: <i>Salmonella paratyphi (S. paratyphi)</i> caused 23.5% of culture-proven enteric fever cases. Most cases had normal leukocyte counts, eosinopenia, and elevated CRP. CRP does not predict fever defervescence. Fever typically resolved in 4–5 days, with paratyphoid fever resolving earlier. Combination therapy was used in over two-thirds of cases. Clinical significance: <i>Salmonella paratyphi (S. paratyphi)</i> is a significant cause of enteric fever in children. There seems to be no clear benefit for combination therapy from our small retrospective data, but study limitations preclude drawing accurate conclusions. Future areas of research interest will include an effective vaccine for paratyphoid fever and a randomized clinical trial on single vs combination therapy in enteric fever.https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1408culture-proven enteric feverdrug susceptibility in enteric feverenteric fever in childrenprescription patterns in enteric fever<i>salmonella typhi</i><i>paratyphi</i> in indian children |
| spellingShingle | Divya Priyadharshini Mobill Clinton Nandini Sethuraman Mathrubootham Sridhar Vidya Krishna Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children Pediatric Infectious Disease culture-proven enteric fever drug susceptibility in enteric fever enteric fever in children prescription patterns in enteric fever <i>salmonella typhi</i> <i>paratyphi</i> in indian children |
| title | Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children |
| title_full | Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children |
| title_fullStr | Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children |
| title_full_unstemmed | Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children |
| title_short | Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children |
| title_sort | clinical profile and prescription patterns in culture proven enteric fever in children |
| topic | culture-proven enteric fever drug susceptibility in enteric fever enteric fever in children prescription patterns in enteric fever <i>salmonella typhi</i> <i>paratyphi</i> in indian children |
| url | https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1408 |
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