To evaluate the clinical and laboratory findings in children admitted with enteric fever.
Material and Methods: This retrospective observational study was conducted in the Department of Pediatrics of a tertiary care hospital in North India. Medical records of children admitted with a diagnosis of enteric fever (Widal positive or blood culture positive) within a period of one year from July 2018 to June 2019 were retrieved and analyzed. Total 110 children aged below 14 years with enteric fever were included in this study. In each case, the clinical and demographic details and laboratory investigations reports including the blood culture reports and antibiotic sensitivity pattern were collected from the hospital records and analysed.
Results: Out of 110 cases, 75 cases (68.18%) were males and 35 cases (31.82%) were females. Most of the cases were aged between 5 and 10 years (50%). The most common symptom was fever (100%), followed by anorexia (64.55%), vomiting (48.18%), pain abdomen (19.09%), diarrhoea (13.64%), headache (11.82%), and cough (8.18%). The most common sign we observed was coated tongue in 50.90%, hepatomegaly in 44.55%, splenomegaly in 20.90%, hepatosplenomegaly in 12.73% of cases and pallor in 7.27% of cases. Anemia was found in 23 (20.90%) cases, leucopenia and leucocytosis was observed in 39 (35.45%) cases and 16 (14.55%) cases, respectively. Differential leukocyte count was suggestive of neutropenia in 45 (40.90%) cases and neutrophilia in 30 (27.27%) cases. Thrombocytopenia was present in 18 (16.36%) cases. SGOT levels were elevated (>200IU/ml) in 17 (15.45%) cases and SGPT (>200IU/ml) in 15(13.63%) cases. Blood culture was positive for Salmonella Typhi in 7 (6.36%) patients with all isolates sensitive to third gen cephalosporins and fluoroquinolones. 75 (68.89%) cases had a hospital stay of more than 7 days and 33 (30%) required a change of antibiotic to fluoroquinolones.
Conclusion: Typhoid fever is a common paediatric illness with high morbidity and having varied clinical and laboratory presentation. Blood culture though considered standard is rarely positive, mostly due to previous oral antibiotic therapy. This major public health issue can be tackled by bringing awareness among people regarding disease transmission and its various preventive measures.