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VOLUME 25 , ISSUE S2 ( May, 2021 ) > List of Articles

INVITED ARTICLE

Typhoid and Enteric Fevers in Intensive Care Unit

Abhijeet Raha

Keywords : Ceftriaxone, Enteric fever, Fever, Fluoroquinolones, Gram-negative bacilli, ICU

Citation Information :

DOI: 10.5005/jp-journals-10071-23842

License: CC BY-NC 4.0

Published Online: 01-05-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Enteric fever (typhoid and paratyphoid)is caused by Salmonella typhi and Salmonella paratyphi. It is spread by fecal-oral route, largely through contamination of water and foodstuff. Developing countries are the worst affected. It takes 7 – 21 days from ingestion of the organism to manifestation of symptoms which are generally Fever, relative bradycardia, and pain abdomen. Hepatosplenomegaly, intestinal bleeding, and perforation are the features at various stages of the disease. The bacteria invade the submucous layer and proliferate in the Payer\'s patches. Blood culture is the gold standard for diagnosis but it is only rarely positive. Fluroquinolones, cephalosporins, and azithromycin are antibiotics of choice. There is increasing evidence of the development of resistance to all antibiotics. Salmonella sepsis, though uncommon, can occur.Intestinal perforation, peritonitis, and secondary sepsis are complications that may require intensive care unit management.


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  1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet 2017;390(10100): P1211–P1259.DOI: 10.1016/S0140-6736(17)32154-2.
  2. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390(10100):P1151–P1210. DOI: 10.1016/S0140-6736(17)32152-9.
  3. John J, Van Aart CJ, Grassly NC. The burden of typhoid and paratyphoid in India: Systematic review and meta-analysis. PLoSNegl Trop Dis 2016;10(4):e0004616.DOI: 10.1371/journal.pntd.0004616.
  4. Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J. Typhoid fever in the United States, 1999–2006. JAMA2009;302(8):859–865.DOI: 10.1001/jama.2009.1229.
  5. Cruz Espinoza LM, Mc Creedy E, Holm M, Im J, Mogeni OD, Parajulee P, et al. Occurrence of typhoid fever complications and their relation to duration of illness preceding hospitalization: a systematic literature review and meta-analysis.Clin Infect Dis 2019;69 (Suppl. 6):S435–S448. DOI:10.1093/cid/ciz477.
  6. Bhandari J, Thada PK, DeVos E. Typhoid fever [Updated 2020 Nov 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
  7. Connor BA, Schwartz E. Typhoid and paratyphoid fever in travellers. Lancet Infect Dis 2005;5(10):623–628. DOI: 10.1016/S1473-3099(05)70239-5. PMID: 16183516.
  8. Khan M. A plausible explanation for male dominance in typhoid ileal perforation. Clin Exp Gastroenterol2012;5:213–217. DOI: 10.2147/CEG.S36569. PMID: 23180972; PMCID: PMC3501370.
  9. Upadhyay R, Nadkar MY, Muruganathan A, Tiwaskar M, Amarapurkar D, Banka NH, et al. API recommendations for the management of typhoid fever.J Assoc Physicians India 2015;63 (11):77–96. PMID: 29900721
  10. Khan S, Harish BN, Menezes GA, Acharya NS, Parija SC. Early diagnosis of typhoid fever by nested PCR for flagellin gene of Salmonella enterica serotype Typhi. Indian J Med Res 2012;136(5):850–854. PMID: 23287134
  11. Darton TC, Baker S, Randall A, Dongol S, Karkey A, Voysey M, et al. Identification of novel serodiagnostic signatures of typhoid fever using a Salmonella proteome array. Front Microbiol 2017;8:1794.DOI: 10.3389/fmicb.2017.01794.
  12. Zurfluh S, Baumgartner T, Meier MA, Ottiger M, Voegeli A, Bernasconi L, et al. The role of metabolomic markers for patients with infectious diseases: implications for risk stratification and therapeutic modulation. Expert Rev Anti Infect Ther 2018;16(2):133–142.DOI: 10.1080/14787210.2018.1426460.
  13. Sharma P, Dahiya S, Manral N, Kumari B, Kumar S, Pandey S, et al. Changing trends of culture-positive typhoid fever and antimicrobial susceptibility in a tertiary care North Indian Hospital over the last decade. Indian J Med Microbiol 2018;36(1):70–76.DOI: 10.4103/ijmm.IJMM_17_412.
  14. Sur D, Barkume C, Mukhopadhyay B, Date K, Ganguly NK, Garrett D. A retrospective review of hospital-based data on enteric fever in India, 2014–2015. J Infect Dis 2018;218(S4): S206–S213. DOI: 10.1093/infdis/jiy502.
  15. Thompson CN, Karkey A, Dongol S, Arjyal A, Wolbers M, Darton T, et al. Treatment response in enteric fever in an era of increasing antimicrobial resistance: an individual patient data analysis of 2092 participants enrolled into 4 randomized, controlled trials in Nepal. Clin Infect Dis2017;64(11):1522–1531. DOI: 10.1093/cid/cix185 [Erratum in: Clin Infect Dis2017;65(8):1431–1433]. PMID: 28329181; PMCID: PMC5434338.
  16. WHO Guidelines for the Management of Enteric fever 2011. Available athttp://apps.who.int/medicinedocs/documents/s20994en/s20994en.pdf.
  17. Marchello CS, BirkholdM, Crump JA. Complications and mortality of typhoid fever: aglobal systematic review and meta-analysis.J Infect 2020;81(6):902–910.DOI: 10.1016/j.jinf.2020.10.030.
  18. Coppolino F, Gatta G, Di Grezia G, Reginelli A, Iacobellis F, Vallone G, et al. Gastrointestinal perforation: ultrasonographic diagnosis.Crit Ultrasound J2013;5(Suppl. 1):S4. DOI:10.1186/2036-7902-5-S1-S4.
  19. Adu-Gyamfi R, Hoosain F, Chetty S. Salmonella typhi– a quiet bacteria with a loud message: an ICU case report. Bali J Anaesthesiol 2019;3(2):129–132. DOI:10.15562/bjoa.v3i2.161.
  20. Chanler-Berat J, Birungi A, Dreifuss B, Mbiine R. Typhoid intestinal perforation: Point-of-care ultrasound as a diagnostic tool in a rural Ugandan Hospital. Afr J Emerg Med 2016;6(1):44–46. DOI: 10.1016/j.afjem.2015. 09.004. PMID: 30456063; PMCID: PMC6233237.
  21. Adu-Gyamfi R, Hoosain F, Chetty S. Salmonella typhi– a quiet bacteria with a loud message: an ICU case report.Bali J Anaesthesiol 2019; 3(2):129–132. DOI: 10.15562/bjoa.v3i2.161.
  22. Nair A, Naik V, Rayani B. FAST HUGS BID: Modified mnemonic for surgical patient. Indian J Crit Care Med 2017; 21 (10):713-714.
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