ATYPICAL PRESENTATION OF ENTERIC FEVER

Abstract

Background: The typical symptoms of typhoid fever include a high temperature, toxaemia, constipation during the first week of a fever, complications from encephalopathy, and perforation during the third week. However, the traditional typhoid fever appearance has significantly modified since then. Our purpose is to research typhoid fever's atypical symptoms, such as hepatomegaly, neutrophilia, bone marrow depression, etc.

Material & methods: All patients who fulfilled the inclusion criteria and visited medical unit 4A of Bolan medical complex Hospital Quetta were included. After ethical approval, informed and written consent, a detailed clinical history was acquired, physical examination was done, including liver span, consciousness level and relevant investigations were done to identify bone marrow depression and Neutrophilia.

Result: Total of 513 patients with enteric fever were included. 333 (64.9%) were males & 180 (35.1%) where females with the mean age was 35.17+11.807 years. Atypical presentation of enteric fever was encephalopathy in 20, hepatomegaly in 40, bone marrow depression in 43 and neutrophilia in 77. The association of both age and gender with encephalopathy, hepatomegaly, bone marrow depression, and neutrophilia were not statistically significant, and p-value was > 0.05.

Conclusion: Atypical manifestations do not necessarily mean a worse prognosis in typhoid fever. Patients having high fever presenting with encephalopathy, hepatomegaly, neutrophilia or bone marrow depression in a typhoid endemic area, should be suspected of this disease.