Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The records of 104 patients with culture-proven enteric fever were reviewed and evaluated as to the clinical signs, laboratory findings, pathologic features and complications of the disease. One patient with fatal disseminated intravascular coagulation and enteric fever is also presented. Fever and bradycardia were the leading clinical signs followed by splenomegaly, hepatomegaly and rose spots. The principal complications of enteric fever included anemia, typhoid hepatitis, relapse and bleeding. Evidence of typhoid hepatitis was present in 30% of the patients tested. The pathology consisted of typhoid nodules of variable frequency and size depending upon the severity of the condition. The relationship of typhoid hepatitis to relapse seems to be more than coincidental as four out of seven patients who had relapse had abnormal liver tests. The occurrence of disseminated intravascular coagulation in enteric fever is rare; however, awareness of such a potential complication may be life-saving to the patient.
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PMID:Enteric fever: a clinicopathologic study of 104 cases. 64 89

Twenty-seven cases of enteric fever were diagnosed between January 1961 and February 1977 at a medium-sized urban hospital. Nineteen of the patients had recently travelled abroad. Fever was the only constant finding, and four patients noted fever and headache as their only symptoms. Splenomegaly was present in 30% and rose spots in just 11%. Enteric fever was initially suspected in only 63% of cases, and a mean of 4.8 days elapsed after admission before specific therapy was instituted. Salmonella was cultured from blood samples in 19 of 24 patients and from stool specimens in 21 of 27, but was never isolated from the urine. Serum O agglutinins, while eventually present in 54% of the patients tested, did not help in establishing an early diagnosis. No deaths occurred, though two patients sustained relapses. Sporadic enteric fever is unlikely to be suspected unless associated with recent foreign travel, but is easily diagnosed by usual culture methods.
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PMID:Epidemiologic and clinical features of sporadic Salmonella enteric fever. 74 58

In South Vietnam, the first Salmonella typhi resistant to chloramphenicol were isolated at the end of 1971; this resistance spread rapidly to two-thirds of S. typhi isolated; it is due to resistance plasmids which parasite most strains of S. typhi identified in Vietnam. The typhoid endemy turned into an epidemic en 1972. The clinical symptoms of typhoid fever remained just as few as before: often only a high temperature; splenomegaly is rare, hepatomegaly more frequent. Complications, specially associated ones, have been more frequently observed since 1972; the evolution of the disease is slower. Although costly, a high dose of ampicillin often proves clinically active. For the moment, an association of trimethoprime and sulfamethoxazole remains the least expensive of efficient treatments.
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PMID:[Typhoid fever in south Vietnam to day (author's transl)]. 104 59

Multidrug resistant typhoid fever (MDRT) is becoming an alarming public health problem in and around Pondicherry, South India. A retrospective review of the multidrug resistant typhoid fever cases admitted to the paediatrics ward of JIPMER Hospital, Pondicherry (India) during 1990 is presented. Prolonged pyrexia, chills and rigors, toxaemia, and tender hepatomegaly often more than 3 cm below the costal margin (often without splenomegaly) were striking features of MDRT cases. The incidence of complications was also greater. Positive blood cultures were observed even after weeks of antibiotic therapy, indicating persistent bacteraemia; resistance was almost always observed for multiple drugs (two or more). The fluoroquinolone group of drugs such as ciprofloxacin have been found to be the best for MDRT in terms of rapid response and cost effectiveness. Cefotaxime has moderate efficacy.
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PMID:Multidrug resistant enteric fever. 149 26

Of 103 cases of typhoid fever admitted to the Pediatric Wing of our hospital during the months of August 1989 to April 1990, 82.5% were resistant to chloramphenicol, ampicillin and co-trimoxozole. Nearly 87% children were in the age group of 3-10 years. Fever was present in all and splenomegaly in 90.2% cases. Urinary retention during the course of illness was present in 2 cases. The positivity rate of blood culture, bone marrow culture and Widal test was 83.7, 100 and 13.5%, respectively. Majority of the strains were of Phage 51-Type I. For the treatment of multidrug resistant cases gentamicin and furazolidine proved ineffective. Ciprofloxacin was tried in 85 cases and was found to be effective in all cases with no side effects.
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PMID:Multidrug resistant typhoid fever: study of an outbreak in Calcutta. 160 98

Eighty eight patients presenting with fatal typhoid complications were studied in Abbassia and Embaba fever hospitals during a 4 years period (1987-1991). Criterion of inclusion in the study was either positive blood culture in 70 (80%) cases or postmortem gross appearance of typhoid fever in 18 (20%) cases. Positive blood culture cases included 54 (77%) S. typhi and 16 (23%) S. paratyphi A. Seven (10%) cases were resistant in vitro to chloramphenicol. Postmortem examination performed in 18 (20%) cases revealed typical typhoid ulcers in ileum, jejunum and large intestine. The main clinical picture of 31 toxic, 22 encephalitic or meningeal irritating, 15 gastroenteritic, 9 pneumonic, 8 perforated and 3 haemorrhagic enteric fever cases were discussed. The tetrad of fever, toxic look, bronchitic chest, tumid tympanitic abdomen and splenomegaly was a good sign for suggestion of typhoid diagnosis.
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PMID:Fatal complications of acute enteric fevers. 179 65

The medical records of 370 patients treated for typhoid fever between 1986 and 1988 at the Communicable Disease Centre, Singapore, were reviewed. The disease was generally mild. There was no mortality. Fever was found in 98.4% of patients on admission and diarrhoea in 21%. Cough was predominantly a symptom of children and occurred in 7.1% of patients aged below 15 years. Other symptoms were uncommon. Hepatomegaly was found in 71% and splenomegaly in 47%. Leucopenia was not a helpful diagnostic marker. Chloramphenicol was the drug of choice. The relapse rate was 5.4% and the convalescent and temporary carrier rates 11.6%. The risk of developing the carrier state was significantly higher among patients who were afebrile on admission compared with those who were febrile (P less than 0.001); it was also higher in patients treated with ampicillin as compared to those treated with chloramphenicol (P less than 0.001, chi 2 = 22.7, odds ratio = 5.25, 95% confidence limits: 2.46 and 11.29). The role of ampicillin as a first line treatment for acute typhoid fever may need further re-evaluation.
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PMID:Typhoid fever in Singapore: a review of 370 cases. 194 16

Thirty six patients with culture-proven enteric fever and 15 patients of fever with etiology other than enteric fever as a control group were studied, with special reference to hepatic dysfunction and its relation to clinical features of the disease. Hepatomegaly was observed in 55% of enteric fever patients, and was slightly more common than splenomegaly (50%). Its incidence in typhoid fever (67%) was three times higher than in paratyphoid fever (22%). Hepatic dysfunction occurred in 55% of cases. Jaundice was noted in only 8% of the cases, whereas hyperbilirubinemia (serum bilirubin greater than 1.8 mg %) was present in 17%. Although hepatic manifestations of enteric fever were mild, a small but important group had sufficient hepatic involvement to mimick the clinical picture seen in viral hepatitis, amebic liver disease, and malaria with jaundice. It may be considered of clinical significance, since enteric hepatitis responds very well to specific therapy.
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PMID:The spectrum of hepatic injury in enteric fever. 312 48

An outbreak of typhoid fever occurred among 54 hospital nurses after a picnic. The salient features were fever (100%), nausea and vomiting (46%), loose motions and abdominal pain (13%), and palpable splenomegaly (63%). None of the patients had any major complications. Blood cultures for Salmonella typhi were positive in 81%, blood Widal was positive (1:320 or more) in 43% and suggestive (1:160) in 25% of the blood culture positive patients. A comparable number of patients were administered chloramphenicol or co-trimoxazole and no differences in response were observed. Bacteriological examination of samples of water from the likely sources revealed it to be unfit for human consumption due to gross faecal contamination.
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PMID:An outbreak of typhoid fever in Chandigarh, North India. 348 47

We conducted a pilot study followed by a large clinical trial in Nepal of the use of the capsular polysaccharide of Salmonella typhi (Vi) as a vaccine to prevent typhoid fever. In the pilot study, involving 274 Nepalese, there were no significant side effects of the Vi vaccine; about 75 percent responded with a rise in serum antibodies of fourfold or more. In the clinical trial, residents of five villages were given intramuscular injections of either Vi or, as a control, pneumococcus vaccine dispensed in coded, randomly arranged, single-dose syringes. There were 6907 participants, of whom 6438 were members of the target population (5 to 44 years of age); each was visited every two days. Those with temperatures of 37.8 degrees C or higher for three consecutive days were examined and asked to give blood for culture. Typhoid was diagnosed as either blood culture-positive or clinically suspected on the basis of bradycardia, splenomegaly, and fever, with a negative blood culture. Seventeen months after vaccination, the codes were broken for the 71 patients meeting the criteria for either culture-positive or clinically suspected typhoid. The attack rate of typhoid was 16.2 per 1000 among the controls and 4.1 per 1000 among those immunized with Vi (P less than 0.00001). The efficacy of Vi was 72 percent in the culture-positive cases, 80 percent in the clinically suspected cases, and 75 percent in the two groups combined. These data provide evidence that Vi antibodies confer protection against typhoid. Surveillance continues to determine the duration of Vi-induced immunity.
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PMID:Prevention of typhoid fever in Nepal with the Vi capsular polysaccharide of Salmonella typhi. A preliminary report. 365 77


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