Current trends in typhoid fever

被引:29
作者
Nancy F. Crum
机构
[1] Division of Infectious Diseases, Clinical Investigation Dept. KCA, Naval Medical Center San Diego, San Diego, CA 92134-1005
关键词
Ceftriaxone; Ofloxacin; Azithromycin; Antimicrob Agent; Typhoid Fever;
D O I
10.1007/s11894-003-0064-0
中图分类号
学科分类号
摘要
Typhoid fever, a systemic infection caused by Salmonella enterica serotype typhi, remains an important worldwide cause of morbidity and mortality. Endemic cases in the United States are unusual, with most following foreign travel to the Indian subcontinent, Africa, Asia, or Latin America. The classic findings of typhoid fever include rose spots, relative bradycardia, and stepwise fevers, but unfortunately these signs are frequently absent. Gastrointestinal manifestations may include diffuse abdominal pain, bleeding, perforation, cholecystitis, and cholangitis. The diagnosis should be suspected after collection of the appropriate clinical and travel history with confirmation by blood or bone marrow culture. Novel methods are in development to establish the diagnosis when cultures are negative or unavailable. Multidrug resistance has increased worldwide, and decisions on antimicrobial therapy must take such resistance into account. The empiric treatment of choice is a fluoroquinolone drug; ceftriaxone and azithromycin are alternatives. Preventive strategies include good sanitation and food handling practices along with vaccination of selected groups. Copyright © 2003 by Current Science Inc.
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页码:279 / 286
页数:7
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