Enteric Fever Clinical Presentation at Different Age Groups of Children in Children Complex Multan

Abstract

Objective: To know enteric fever clinical manifestations due to age difference in children <5 years and above or equal 5 years.

Place and Duration: Children Complex Multan from Dec 2015_2016

METHODS: This study was carried out to determine the clinical status of patients with enteric fever. Total patients were 30 ranging between 9 months to 12 years of age were exposed to Widal positive and / or cultured salmonella were selected.

 Findings: The mean age of presentation was 5 ± 3. common clinical features were vomiting (38.8%), fever (100%), cough (28.07%), abdominal pain (27.87%), hepatomegaly (2: 80.55% 47.22%), diarrhea (19.44%),pink spots (8.33%) and relative bradycardia (13.88%). No patient had constipation. Diarrhea was more common in the <5-year-old group, whereas only relative bradycardia was observed in 5-year-old or above age group.  First-line antibiotics used, cefotaxime (2.7%) and cefuroxacin, 31 (86,11%) in four (11.11%) were used. First-line antibiotics failure occurred in 30.5% of patients. 6 (16.66%) patients had serositis, synovitis, 1 (16.67%) had osteomyelitis, shock and spleen abscess including complications. 34 (94.44%) of the children improved, 1 died and 1 was followed. Healing was faster compared to 5 years of age <5 years. First line resistance to third generation cephalosporin antibiotics occurs in 30% of our patients.

Conclusion: Diarrhea was more frequent in <5 year old group, only in 5 year age group patients where relative bradycardia was observed. In any case Constipation was not a feature. In both age groups Features clinically such as vomiting, fever, cough, abdominal pain,  hepatomegaly, diarrhea,  pink spots and splenomegaly were present.