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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Headache, nuchal rigidity, positive Kernig's sign, and even convulsions may be observed during severe bacterial infections such as pneumonia, pyelonephritis, typhoid fever, and bacillary dysentery. In such cases, meningitis can be excluded only by documentation of normal cerebrospinal fluid (CSF). The authors describe four children with lobar pneumonia in whom the clinical signs of meningeal irritation were associated with a mild increase in the white blood cell count in the CSF (pleocytosis) although there was no other evidence of meningeal infection.
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PMID:Cerebrospinal fluid pleocytosis in children with pneumonia but lacking evidence of meningitis. 834 51

A diagnosis of blood culture-positive typhoid (TF; n = 39) or paratyphoid (PTF; n = 17) fever was made in 56 patients admitted to two Dutch university hospitals in the period 1984-1990. The group of TF patients constituted 9% of the reported national total during those years. A retrospective analysis of available clinical, laboratory and epidemiological data was carried out. Without exception, infections were contracted during travel abroad, especially to India and Indonesia. The clinical features and the response to antimicrobial treatment of TF and PTF proved essentially the same. Fever, headache and anorexia were important symptoms; rose spots and splenomegaly were found in 18/38 and 10/39 with S. typhi respectively. Most patients had a normal white blood cell count; less than half of the patients had thrombocytopenia. A positive Widal-test was found in 15/24 patients with S. typhi. 18/39 patients with S. typhi had been vaccinated; 10 did not know. Amoxycillin was the preferred antimicrobial agent in 69% of cases. Median defervescence time was 5 days in TF and 4 days in PTF. Relapse occurred in 3 TF cases. The recurrence rate after amoxycillin treatment was 7.6%. Profuse intestinal bleeding (1x), septic shock (1x) and cholangitis plus ARDS (1x) were major complications, seen in TF patients only. All patients recovered fully. None of the isolated strains of S. typhi or S. paratyphi proved multiresistant. Surveillance data from the Dutch National Institute of Public Health and Environmental Protection suggest that multidrug-resistance of S. typhi is increasing, especially in strains imported from countries such as India and Pakistan.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Abdominal typhus and paratyphoid fever in 2 academic hospitals: 1984-1990]. 843 74

The clinical and immunological responses to typhoid vaccination with parenteral and oral vaccines in two groups of 30 adult male subjects were studied. Specific anti-Salmonella typhi cell-mediated immunity and total or specific anti-lipopolysaccharide faecal immunoglobulin (Ig) A titres in vaccinated subjects were monitored. Cellular antibacterial activity was significantly increased only in orally vaccinated subjects. Serum arming activity and inhibition experiments suggested an IgA-dependent cellular cytotoxicity in those orally vaccinated. In these subjects, a total and anti-lipopolysaccharide faecal IgA increase was observed lasting up to 8 months after completion of the vaccination schedule. In parenteral vaccinated subjects, an early onset transitory increase of IgM rheumatoid factor was observed. Oral vaccine was well tolerated and free of side effects, whereas 65% of parenterally vaccinated subjects reported side effects such as fever, headache, malaise and local tenderness in the injection site.
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PMID:Clinical and immunological response to typhoid vaccination with parenteral or oral vaccines in two groups of 30 recruits. 848 16

Murine typhus, caused by Rickettsia typhi, is an important zoonosis in all parts of the world. The disease is transmitted from rodents to humans by fleas. In this article we describe the first three cases of serologically proven murine typhus imported into Norway during the 1990s. The patients were Norwegian tourists who had visited respectively Guinea-Bissau, Crete and Thailand. They all became acutely ill with fever, chills and severe headache 1-10 days after return to Norway. None of them had a rash. Two patients were admitted to hospital, and one was treated with ciprofloxacin for suspected typhoid fever. All the patients recovered without sequelae. The diagnosis of murine typhus was based on detection of IgM-anti-bodies against R typhi in serum samples during reconvalescence.
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PMID:[Endemic typhus imported to Norway]. 926 2

There is no objective data on the value of individual clinical symptoms or signs in the diagnosis of enteric fever in a febrile patient. The purpose of the study was to assess the value of some clinical and simple laboratory features in the diagnosis of enteric fever. One hundred & six patients with microbiologically confirmed enteric fever and 170 patients with other established febrile illnesses were included in the evaluation. History of stepladder pattern of rise of temperature, loose motions, relative bradycardia and coated tongue proved to be powerful markers of enteric fever with high specificity (100%, 94.71%, 94.71%, 94.12% respectively), positive and negative predictive values. Headache, hepatomegaly and splenomegaly were moderately powerful. ESR and WBC count appeared to have little value in the diagnosis of enteric fever. Pattern of onset and loose motions did not discriminate between typhoid and paratyphoid fever. Most of these patients had illness persisting beyond one week by which viral infections and infectious enterocolitides were largely excluded. Elucidation of power of these markers in distinguishing enteric fever from other febrile illnesses with the help of better designed prospective studies would lessen our dependence on expensive and time consuming laboratory investigations.
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PMID:Value of clinical features in the diagnosis of enteric fever. 946 34

Seasonal fluctuations were studied in the incidence of characteristic abdominal fever symptoms, such as headache, insomnia, asthenia, skin pallor, roseolous eruptions, protracted fever, drop in blood pressure, relative bradycardia, dicrotia, typhoid tongue, enlargement of the liver and spleen, meteorism, constipation, palpable crepitation in the right iliac region, manifest leucopenia. Some symptoms occurred with almost equal frequency in different seasons of the year. In adults, severity of some typhoid symptoms was the greatest, duration the longest, degree the highest in spring, followed, in decreasing rank order by autumn > summer > winter; in children: spring > summer > autumn > winter.
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PMID:[The seasonal characteristics of the course of abdominal typhus]. 949 29

A study was undertaken to determine the role of typhoid in febrile illness. It was found that in 1992, Salmonella typhi, the causative agent of typhoid, played a 2.3% role in 25404 diagnostic specimens sent to Mulago Hospital, Kampala, the largest hospital in Uganda. The rates of isolation fell gradually from 2.3% in 1992 to 0.3% by 1995. Instead malaria was found to play a major role in febrile illnesses. Out of 355 patients attending a private clinic in Kampala, whose blood was examined for both malaria and typhoid, 97% were positive for malaria parasites compared to 0.84% with significant O and H Salmonella typhi antibody titres of > 1:80. Also malaria parasites were found in 60% (out of 105) of patients who had had persistent fevers and in whom doctors had also requested for HIV antibodies. Those who had HIV antibodies alone were six per cent and the ones with both were 28%, a finding which showed relatively low association of malaria and HIV. Where multiple tests were requested on one patient having general malaise or body joint pains and/or constant headaches, malaria was found to play a major role (73%) compared to syphilis (4.3%) and brucellosis (13.3%). Malaria parasites were seen in normal sizes and in somehow young or stunted forms. The latter were found more often in patients who had experienced one or a combination of the following: intermittent fevers, backache, headache, tiredness, joint and/or neck pains, and who had already received treatment for malaria.
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PMID:Selected laboratory tests in febrile patients in Kampala, Uganda. 964 Aug 25

Eleven patients referred to a hospital in South Africa with suspected tropical diseases such as malaria, typhoid fever and South African tick bite fever were found to be suffering from primary human immunodeficiency virus (HIV) infection. Hospital records were reviewed retrospectively in those acutely ill, febrile patients where a clinical suspicion of HIV seroconversion existed and no other diagnosis could be found. A history of recent travel, particularly to malarious areas, was given by most of these patients. The clinical presentation was dominated by high fevers and headaches. The most helpful pointers to primary HIV infection included a characteristic palatal enanthem, leucopenia and thrombocytopenia. Ironically, the history of recent travel appeared to have confounded the diagnosis despite the fact that travel has often been associated with the acquisition of HIV in Africa. Recognition of primary HIV infection masquerading as a tropical disease may result in more frequent diagnosis of this serious condition.
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PMID:Primary HIV infection diagnosed in South Africa masquerading as another tropical disease. 985 Mar 99

A 45 year old male came with fever, headache, altered sensorium pallor and lower gastrointestinal bleeding. Laboratory investigations confirmed typhoid fever. Magnetic resonance imaging (MRI) was suggestive of acute disseminated encephalomyelitis.
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PMID:Acute disseminated encehalomyelitis with typhoid fever. 1077 99

Typhoid fever, a systemic infectious disease caused by Salmonella typhi, is classically characterized by fever, paradoxical bradycardia, abdominal pain, and a rose colored rash. This was a retrospective review of 21 confirmed cases over a 5-year period. Mean age was 32.6 years (range 2-60 years), and Mexico (7/21) and El Salvador (3/21) represented the most common countries of origin. Recent travel to an endemic area was noted in 14 patients. The most common complaints were fever (15/21), headache (10/21), abdominal pain (9/21), and diarrhea (6/21). Average duration of symptoms before presentation to the Emergency Department (ED) was 7.9 days. High fever associated with bradycardia was noted in 12 patients. Leukopenia was present in 7 patients. Blood culture was the most sensitive confirmatory test while the Widal test was positive in 7 out of 11 cases. Fever of unknown origin (12/21), followed by presumed typhoid fever (3/21) were the most common ED diagnoses. It is important to recognize that patients with typhoid fever may present to EDs in the US and this disease should be included in the differential diagnosis of febrile patients from Latin America or those with a history of recent travel to endemic countries.
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PMID:Emergency department presentations of typhoid fever. 1107 22


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