Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between January 1976 and December 1978, the Microbiology Department of University College Hospital (UCH) Ibadan, isolated Salmonella typhi from the blood cultures of 93 children aged 0-14 years, who were admitted to the paediatric wards. Clinical case notes were retrieved and reviewed in 64 (68.8%) of them. Fifteen (23%) of the 64 children were less than one year of age while 22 (34%) were under the age of five years. The commonest presenting symptoms were fever, anorexia, diarrhoea and vomiting. A febrile convulsion was the presenting symptom in 13 (20%) of the patients, all of whom were under the age of five years. Hepatomegaly was almost twice as frequently observed as splenomegaly. Intestinal perforation was present in five of the patients. There was a high proportion of SS children who presented with fever, pallor, jaundice, generalized aches and pains and other clinical features of sickle cell disease and it is possible that such children are specially susceptible to typhoid fever. A clinical diagnosis of typhoid fever on admission was made in only 14 of the 64 children. Reasons are given for the low index of suspicion and it is suggested that any child with unremitting fever after adequate anti-malarial chemotherapy should be treated for enteric fever.
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PMID:Problems in the clinical diagnosis of typhoid fever in children in the tropics. 618 69

A major common-source, foodborne epidemic of typhoid fever occurred in San Antonio, Tex, in the fall of 1981, involving 80 verified cases. We summarize the clinical course of our 34 patients who had a nonspecific symptom complex that included at the initial examination fever (32 patients, 93%), headache (19 patients, 57%), diarrhea (11 patients, 33%), and anorexia (ten patients, 30%). The most common initial diagnoses were urinary tract and upper respiratory tract infections. The subsequent isolation of Salmonella typhi from blood cultures was usually unexpected. Physical findings were different from two previous series originating in the United States. Hepatomegaly was noted in only 7% (two patients), splenomegaly was noted in 13% (four patients), and rose spots were noted in 5% (two patients) of the patients. Liver function test results, however, were abnormal in 32 (95%) of the 34 patients (mean SGOT, 155 IU/mL). Typhoid fever, as seen in this outbreak, was notable for its nonspecific and mild manifestation and uniformly favorable outcome.
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PMID:Typhoid fever. An epidemic with remarkably few clinical signs and symptoms. 670 25

Culture-proven cases of enteric fever (182) were studied during the period May 1991 to April 1992; 39 per cent of the children were below 3 years. There was male preponderance. Infants presented within first few days of onset of fever with severe systemic manifestation, such as repeated convulsion, puffiness of face and oedema, massive hepatomegaly, and bleeds due to thrombocytopenia. Only 49-52 per cent of the cultures were sensitive to ampicillin, chloroamphenicol, and cotrimoxazole. The infants were treated with cephalosporin such as cefotaxime or quinolones as ciprofloxacin, since 100 per cent of the cultures were sensitive to this drug. Three infants had meningitis, two interstitial nephritis, and six had marrow hypoplasia. Two children who had been treated prior to admission with ampicillin or chloroamphenicol died within 48 h of admission, one of a liver abcess and peritonitis, and the other due to meningitis. Markedly prolonged hypothermia was seen during recovery in few cases. Forty-six per cent of infants had complications as against 2 per cent in older children. Drug Resistant Salmonella typhi infection seems to have a rapidly progressive severe course with multiple organ involvement such as meningitis, liver abcess, nephritis, and marrow hypoplasia. Initiation of appropriate antibiotics depending on local sensitivity pattern is needed early in the disease to avoid mortality and morbidity.
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PMID:Patterns of resistant Salmonella typhi infection in infants. 772 33

Thirty one children with typhoid fever aged 2 months to 12 years and blood culture positive for multidrug resistant S. typhi were prospectively studied for their hepatic functions at the time of hospitalization and 2-3 weeks after completion of antibiotic therapy. Hepatic manifestations included hepatomegaly (51.6%); jaundice (16.1%); raised levels of serum glutamic oxaloacetic transaminase (SGOT) (61.3%), serum glutamic pyruvic transaminase (SGPT) (48.4%), alkaline phosphatase (AP) (22.6%) and serum bilirubin (SB) (6.1%); reduced levels of serum albumin (SA) (41.9%); prolonged prothrombin time (PT) (9.7%) and abnormal ultrasound abdomen (19.3%). Hepatic dysfunction was a notable feature even in those cases without hepatomegaly, with raised levels of SGOT (60%), SGPT (40%), AP (20%), SB (6.7%), decreased SA (53.3%) and prolonged PT (6.7%). There was no correlation between the degree of hepatic enlargement or hyperbilirubinemia with abnormalities in liver functions. Hepatic dysfunction was noticed to be transient, as all these parameters returned to normal within 2-3 weeks after successful antibiotic therapy.
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PMID:Hepatic manifestations in typhoid fever. 789 Mar 43

A 24-year-old Chinese woman was admitted for cholestatic jaundice following a short history of fever associated with headache and diarrhoea. She had mild hepatomegaly. Initial laboratory investigations were non-contributory. A percutaneous liver biopsy revealed inflammatory changes more in keeping with a systemic infection than a primary hepatitic problem. Repeat blood and stool cultures finally grew salmonella typhi. Jaundice is a rare manifestation of typhoid fever; it occurs in less than one-third of patients with hepatomegaly. Such a presentation may mimic primary hepatic infections. Awareness of this rare occurrence in typhoid fever would help in early diagnosis and therapy.
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PMID:Uncommon presentation of typhoid fever: a case report. 812 63

A review was made of the clinical characteristics and evolution of all patients over 14 years old with typhoid fever who were treated at the Albert Schweitzer Hospital in Haiti from January 1989 through July 1991. Two hundred and seventeen patients were studied. Their most common symptoms were fever (100%), diarrhea (64.1%), and abdominal pain (51.2%). Splenomegaly and hepatomegaly were rarely noted. Sixty-eight patients (31.3%) were lost to follow-up, 129 (59.4%) were cured, and 20 (9.2%) died. There was a tendency for patients who were ill longer before seeking medical assistance to experience higher mortality. The data also indicate that patients with central nervous system involvement had a less favorable prognosis than other patients. Overall, the high incidence of hospital-reported cases (74 cases per 100,000 inhabitants) shown by these and other data makes it clear that typhoid fever is a highly prevalent infection in rural Haiti. At present, it appears that the only hope for effectively controlling the disease is by educating the population at risk, not only to prevent the disease but also to seek early medical assistance after becoming infected. Typhoid fever patients with a long history of illness before consultation may have a less favorable prognosis than other patients and should be kept under close observation. In addition, any suspected typhoid fever patient with signs of central nervous system involvement should be treated promptly with high-dose steroids, besides receiving an adequate antibiotic regimen.
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PMID:Typhoid fever in rural Haiti. 831 61

Enteric fever is still a common health problem in many countries, especially in children. Thus a ten-year retrospective study was carried out to evaluate the clinical and laboratory properties of enteric fever and the incidence of antimicrobial resistance in children. Throughout the past 10 years, Salmonella was isolated in 105 patients by blood culturing, 27 of which were Salmonella typhi. Most of the patients were above the age of two. Besides the typical symptoms and signs of enteric fever, 29.2% of the patients had some neurologic findings. Besides, 68.5% had elevated liver enzymes while only 44.4% had hepatomegaly with or without splenomegaly. Anemia was present in 44%, leukopenia in 16% and leukocytosis in 11.1% of the cases. The emergence of antimicrobial resistance during the last five years against ampicillin, chloramphenicol and trimetoprim-sulfamethoxazole has created a challenge in treating these infections.
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PMID:Salmonella typhi infections. A 10-year retrospective study. 870

Early appearance of clinical jaundice is rare presentation in enteric fever. Although abnormal biochemical tests suggestive of hepatic involvement has already been suggested in 23-60 per cent of cases. The early hepatic changes have been attributed to generalised bacteraemia, persistence of hepatomegaly and hepatic lesion during pyrexial stage. But the typhoid hepatitis has been ignored as a clinical entity. In this report the importance of typhoid hepatitis and its clinical significance for the diagnosis of enteric fever is highlighted, particularly at places where viral hepatitis and hepatic amoebiasis are usually common and enteric fever is endemic.
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PMID:Typhoid hepatitis: report of two cases. 882 55

Typhoid Hepatitis is a rare presentation of typhoid fever, clinically suspected in patients with persistent fever hepatomegaly and jaundice and especially in cases where the liver function tests show predominantly conjugated hyperbilirubinemia, modest elevation of liver enzymes and negative serology for viral hepatitis. From January, 1989 to December, 1994, 476 cases were included in this study, 204 with typhoid fever admitted in JPMC Karachi and 272 in Civil Hospital, Quetta. Eleven percent cases had typhoid hepatitis. Nineteen (4%) cases were initially diagnosed as viral hepatitis and 33 (7%) developed jaundice later on. As typhoid is prevalent in Pakistan and typhoid hepatitis is a challenging problem, accurate and simple methods are required for diagnosis in all febrile cases. It should particularly be considered as a differential diagnosis for cases with fever, jaundice and hepatomegaly.
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PMID:Typhoid hepatitis. 892 May 99

The risk factors for mortality were analysed in a consecutive group of 1158 children presenting to the Aga Khan University Medical Center, Karachi, with multidrug resistant typhoid fever that had been proved on culture. There were 19 deaths, representing an overall case fatality rate of 1.6%. Multidrug resistant typhoid was associated with a more severe clinical illness and higher rates of toxicity, hepatomegaly, hypotensive shock, and death. Irrespective of drug resistance status, typhoid fever was found to be a more severe illness in young infants with significantly higher rates of diarrhoea, hypotensive shock, and mortality. Univariate analysis of admission characteristics associated with increased risk for mortality revealed significant association with younger age (p < 0.05), hypotensive shock or hypothermia (p < 0.001), obtundation (p < 0.001), seizures (p < 0.05), anaemia at admission (p < 0.005), and leucocytosis (p < 0.001). Logistic regression analysis of risk factors for mortality showed persistent association of hypothermia, toxicity, and anaemia with mortality. The data provides evidence that multidrug resistant typhoid in childhood is associated with increased risk of mortality, especially in infancy and closer attention to several risk factors for increased morbidity and case fatality rates may lead to improved outcome of treatment.
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PMID:Impact of age and drug resistance on mortality in typhoid fever. 897 60


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