A prospective study of the importance of enteric fever as a cause of non-malarial febrile illness in patients admitted to Chittagong Medical College Hospital, Bangladesh
Fever is a common cause of hospital admission in Bangladesh but causative agents, other than malaria, are not routinely investigated. Enteric fever is thought to be common. Adults and children admitted to Chittagong Medical College Hospital with a temperature of ≥38.0 °C were investigated using a bl...
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| Veröffentlicht in: | BMC infectious diseases 2016-10, Vol.16 (1), p.567-567, Article 567 |
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| creator | Maude, Rapeephan R Ghose, Aniruddha Samad, Rasheda de Jong, Hanna K Fukushima, Masako Wijedoru, Lalith Hassan, Mahtab Uddin Hossain, Md Amir Karim, Md Rezaul Sayeed, Abdullah Abu van den Ende, Stannie Pal, Sujat Zahed, A S M Rahman, Wahid Karnain, Rifat Islam, Rezina Tran, Dung Thi Ngoc Ha, Tuyen Thanh Pham, Anh Hong Campbell, James I van Doorn, H Rogier Maude, Richard J van der Poll, Tom Wiersinga, W Joost Day, Nicholas P J Baker, Stephen Dondorp, Arjen M Parry, Christopher M Faiz, Md Abul |
| description | Fever is a common cause of hospital admission in Bangladesh but causative agents, other than malaria, are not routinely investigated. Enteric fever is thought to be common.
Adults and children admitted to Chittagong Medical College Hospital with a temperature of ≥38.0 °C were investigated using a blood smear for malaria, a blood culture, real-time PCR to detect Salmonella Typhi, S. Paratyphi A and other pathogens in blood and CSF and an NS1 antigen dengue ELISA.
We enrolled 300 febrile patients with a negative malaria smear between January and June 2012: 156 children (aged ≤15 years) and 144 adults with a median (interquartile range) age of 13 (5-31) years and median (IQR) illness duration before admission of five (2-8) days. Clinical enteric fever was diagnosed in 52 patients (17.3 %), lower respiratory tract infection in 48 (16.0 %), non-specific febrile illness in 48 (16.0 %), a CNS infection in 37 patients (12.3 %), urinary sepsis in 23 patients (7.7 %), an upper respiratory tract infection in 21 patients (7.0 %), and diarrhea or dysentery in 21 patients (7.0 %). Malaria was still suspected in seven patients despite a negative microscopy test. S. Typhi was detected in blood by culture or PCR in 34 (11.3 %) of patients. Of note Rickettsia typhi and Orientia tsutsugamushi were detected by PCR in two and one patient respectively. Twenty-nine (9 %) patients died during their hospital admission (15/160 (9.4 %) of children and 14/144 (9.7 %) adults). Two of 52 (3.8 %) patients with enteric fever, 5/48 (10.4 %) patients with lower respiratory tract infections, and 12/37 (32.4 %) patients with CNS infection died.
Enteric fever was confirmed in 11.3 % of patients admitted to this hospital in Bangladesh with non-malaria fever. Lower respiratory tract and CNS infections were also common. CNS infections in this location merit more detailed study due to the high mortality. |
| doi_str_mv | 10.1186/s12879-016-1886-3 |
| format | Article |
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Adults and children admitted to Chittagong Medical College Hospital with a temperature of ≥38.0 °C were investigated using a blood smear for malaria, a blood culture, real-time PCR to detect Salmonella Typhi, S. Paratyphi A and other pathogens in blood and CSF and an NS1 antigen dengue ELISA.
We enrolled 300 febrile patients with a negative malaria smear between January and June 2012: 156 children (aged ≤15 years) and 144 adults with a median (interquartile range) age of 13 (5-31) years and median (IQR) illness duration before admission of five (2-8) days. Clinical enteric fever was diagnosed in 52 patients (17.3 %), lower respiratory tract infection in 48 (16.0 %), non-specific febrile illness in 48 (16.0 %), a CNS infection in 37 patients (12.3 %), urinary sepsis in 23 patients (7.7 %), an upper respiratory tract infection in 21 patients (7.0 %), and diarrhea or dysentery in 21 patients (7.0 %). Malaria was still suspected in seven patients despite a negative microscopy test. S. Typhi was detected in blood by culture or PCR in 34 (11.3 %) of patients. Of note Rickettsia typhi and Orientia tsutsugamushi were detected by PCR in two and one patient respectively. Twenty-nine (9 %) patients died during their hospital admission (15/160 (9.4 %) of children and 14/144 (9.7 %) adults). Two of 52 (3.8 %) patients with enteric fever, 5/48 (10.4 %) patients with lower respiratory tract infections, and 12/37 (32.4 %) patients with CNS infection died.
Enteric fever was confirmed in 11.3 % of patients admitted to this hospital in Bangladesh with non-malaria fever. Lower respiratory tract and CNS infections were also common. CNS infections in this location merit more detailed study due to the high mortality.</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><identifier>DOI: 10.1186/s12879-016-1886-3</identifier><identifier>PMID: 27737634</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Bangladesh - epidemiology ; Blood ; Child ; Child, Preschool ; Complications and side effects ; Dysentery ; Febrile convulsions ; Female ; Fever - etiology ; Fever - microbiology ; Hospitalization - statistics & numerical data ; Hospitals, University ; Humans ; Infant ; Infectious diseases ; Malaria ; Malaria - complications ; Malaria - epidemiology ; Malaria - microbiology ; Malaria - virology ; Male ; Middle Aged ; Respiratory tract ; Risk factors ; Salmonella typhi - isolation & purification ; Salmonella typhi - physiology ; Typhoid fever ; Typhoid Fever - complications ; Typhoid Fever - epidemiology ; Typhoid Fever - microbiology ; Vector-borne diseases ; Waterborne diseases ; Young Adult</subject><ispartof>BMC infectious diseases, 2016-10, Vol.16 (1), p.567-567, Article 567</ispartof><rights>COPYRIGHT 2016 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2016</rights><rights>The Author(s). 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c562t-2b1e28c6dc0ad95fc0a0715f50e7daa4435f9f8ce8206f346403078b4e2db4573</citedby><cites>FETCH-LOGICAL-c562t-2b1e28c6dc0ad95fc0a0715f50e7daa4435f9f8ce8206f346403078b4e2db4573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064917/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064917/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27737634$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maude, Rapeephan R</creatorcontrib><creatorcontrib>Ghose, Aniruddha</creatorcontrib><creatorcontrib>Samad, Rasheda</creatorcontrib><creatorcontrib>de Jong, Hanna K</creatorcontrib><creatorcontrib>Fukushima, Masako</creatorcontrib><creatorcontrib>Wijedoru, Lalith</creatorcontrib><creatorcontrib>Hassan, Mahtab Uddin</creatorcontrib><creatorcontrib>Hossain, Md Amir</creatorcontrib><creatorcontrib>Karim, Md Rezaul</creatorcontrib><creatorcontrib>Sayeed, Abdullah Abu</creatorcontrib><creatorcontrib>van den Ende, Stannie</creatorcontrib><creatorcontrib>Pal, Sujat</creatorcontrib><creatorcontrib>Zahed, A S M</creatorcontrib><creatorcontrib>Rahman, Wahid</creatorcontrib><creatorcontrib>Karnain, Rifat</creatorcontrib><creatorcontrib>Islam, Rezina</creatorcontrib><creatorcontrib>Tran, Dung Thi Ngoc</creatorcontrib><creatorcontrib>Ha, Tuyen Thanh</creatorcontrib><creatorcontrib>Pham, Anh Hong</creatorcontrib><creatorcontrib>Campbell, James I</creatorcontrib><creatorcontrib>van Doorn, H Rogier</creatorcontrib><creatorcontrib>Maude, Richard J</creatorcontrib><creatorcontrib>van der Poll, Tom</creatorcontrib><creatorcontrib>Wiersinga, W Joost</creatorcontrib><creatorcontrib>Day, Nicholas P J</creatorcontrib><creatorcontrib>Baker, Stephen</creatorcontrib><creatorcontrib>Dondorp, Arjen M</creatorcontrib><creatorcontrib>Parry, Christopher M</creatorcontrib><creatorcontrib>Faiz, Md Abul</creatorcontrib><title>A prospective study of the importance of enteric fever as a cause of non-malarial febrile illness in patients admitted to Chittagong Medical College Hospital, Bangladesh</title><title>BMC infectious diseases</title><addtitle>BMC Infect Dis</addtitle><description>Fever is a common cause of hospital admission in Bangladesh but causative agents, other than malaria, are not routinely investigated. Enteric fever is thought to be common.
Adults and children admitted to Chittagong Medical College Hospital with a temperature of ≥38.0 °C were investigated using a blood smear for malaria, a blood culture, real-time PCR to detect Salmonella Typhi, S. Paratyphi A and other pathogens in blood and CSF and an NS1 antigen dengue ELISA.
We enrolled 300 febrile patients with a negative malaria smear between January and June 2012: 156 children (aged ≤15 years) and 144 adults with a median (interquartile range) age of 13 (5-31) years and median (IQR) illness duration before admission of five (2-8) days. Clinical enteric fever was diagnosed in 52 patients (17.3 %), lower respiratory tract infection in 48 (16.0 %), non-specific febrile illness in 48 (16.0 %), a CNS infection in 37 patients (12.3 %), urinary sepsis in 23 patients (7.7 %), an upper respiratory tract infection in 21 patients (7.0 %), and diarrhea or dysentery in 21 patients (7.0 %). Malaria was still suspected in seven patients despite a negative microscopy test. S. Typhi was detected in blood by culture or PCR in 34 (11.3 %) of patients. Of note Rickettsia typhi and Orientia tsutsugamushi were detected by PCR in two and one patient respectively. Twenty-nine (9 %) patients died during their hospital admission (15/160 (9.4 %) of children and 14/144 (9.7 %) adults). Two of 52 (3.8 %) patients with enteric fever, 5/48 (10.4 %) patients with lower respiratory tract infections, and 12/37 (32.4 %) patients with CNS infection died.
Enteric fever was confirmed in 11.3 % of patients admitted to this hospital in Bangladesh with non-malaria fever. Lower respiratory tract and CNS infections were also common. CNS infections in this location merit more detailed study due to the high mortality.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Bangladesh - epidemiology</subject><subject>Blood</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Complications and side effects</subject><subject>Dysentery</subject><subject>Febrile convulsions</subject><subject>Female</subject><subject>Fever - etiology</subject><subject>Fever - microbiology</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Malaria</subject><subject>Malaria - complications</subject><subject>Malaria - epidemiology</subject><subject>Malaria - microbiology</subject><subject>Malaria - virology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Respiratory tract</subject><subject>Risk factors</subject><subject>Salmonella typhi - isolation & purification</subject><subject>Salmonella typhi - physiology</subject><subject>Typhoid fever</subject><subject>Typhoid Fever - complications</subject><subject>Typhoid Fever - epidemiology</subject><subject>Typhoid Fever - microbiology</subject><subject>Vector-borne diseases</subject><subject>Waterborne diseases</subject><subject>Young Adult</subject><issn>1471-2334</issn><issn>1471-2334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNks9u1DAQxiMEoqXwAFyQJS4gkWLHjp1ckJYV0EpFlfh3tbzOJOvKsVPbqegj8ZY4bCldxAH5MJbn943Hnq8onhJ8TEjDX0dSNaItMeElaRpe0nvFIWGClBWl7P6d_UHxKMYLjIloqvZhcVAJQQWn7LD4sUJT8HECncwVoJjm7hr5HqUtIDNOPiTlNCwn4BIEo1EPVxCQikghreb4K-e8K0dlVTDKZmATjM1yax3EiIxDk0om67OmG01K0KHk0Xqbt2rwbkAfoTM6S9feWhgAneSOTFL2FXqr3GBVB3H7uHjQKxvhyU08Kr6-f_dlfVKenX84Xa_OSl3zKpXVhkDVaN5prLq27nPAgtR9jUF0SjFG677tGw1NhXlPGWeYYtFsGFTdhtWCHhVvdnWneTNCp3PfQVk5BTOqcC29MnI_48xWDv5K1pizliwFXtwUCP5yhpjkaKIGa5UDP0dJGlqzPL-2zejzv9ALPweXn7dQrM0DE-IPNSgL0rje53v1UlSuGOc1bSvaZOr4H1ReHYxGewd9Hsq-4OWeIDMJvqchDzXK08-f_p89_7bPkh2rs7FigP727wiWi2_lzrcy-1YuvpU0a57d_fRbxW-j0p8ltujD</recordid><startdate>20161013</startdate><enddate>20161013</enddate><creator>Maude, Rapeephan R</creator><creator>Ghose, Aniruddha</creator><creator>Samad, Rasheda</creator><creator>de Jong, Hanna K</creator><creator>Fukushima, Masako</creator><creator>Wijedoru, Lalith</creator><creator>Hassan, Mahtab Uddin</creator><creator>Hossain, Md Amir</creator><creator>Karim, Md Rezaul</creator><creator>Sayeed, Abdullah Abu</creator><creator>van den Ende, Stannie</creator><creator>Pal, Sujat</creator><creator>Zahed, A S M</creator><creator>Rahman, Wahid</creator><creator>Karnain, Rifat</creator><creator>Islam, Rezina</creator><creator>Tran, Dung Thi Ngoc</creator><creator>Ha, Tuyen Thanh</creator><creator>Pham, Anh Hong</creator><creator>Campbell, James I</creator><creator>van Doorn, H Rogier</creator><creator>Maude, Richard J</creator><creator>van der Poll, Tom</creator><creator>Wiersinga, W Joost</creator><creator>Day, Nicholas P J</creator><creator>Baker, Stephen</creator><creator>Dondorp, Arjen M</creator><creator>Parry, Christopher M</creator><creator>Faiz, Md Abul</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QL</scope><scope>7T2</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161013</creationdate><title>A prospective study of the importance of enteric fever as a cause of non-malarial febrile illness in patients admitted to Chittagong Medical College Hospital, Bangladesh</title><author>Maude, Rapeephan R ; Ghose, Aniruddha ; Samad, Rasheda ; de Jong, Hanna K ; Fukushima, Masako ; Wijedoru, Lalith ; Hassan, Mahtab Uddin ; Hossain, Md Amir ; Karim, Md Rezaul ; Sayeed, Abdullah Abu ; van den Ende, Stannie ; Pal, Sujat ; Zahed, A S M ; Rahman, Wahid ; Karnain, Rifat ; Islam, Rezina ; Tran, Dung Thi Ngoc ; Ha, Tuyen Thanh ; Pham, Anh Hong ; Campbell, James I ; van Doorn, H Rogier ; Maude, Richard J ; van der Poll, Tom ; Wiersinga, W Joost ; Day, Nicholas P J ; Baker, Stephen ; Dondorp, Arjen M ; Parry, Christopher M ; Faiz, Md Abul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c562t-2b1e28c6dc0ad95fc0a0715f50e7daa4435f9f8ce8206f346403078b4e2db4573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Bangladesh - epidemiology</topic><topic>Blood</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Complications and side effects</topic><topic>Dysentery</topic><topic>Febrile convulsions</topic><topic>Female</topic><topic>Fever - etiology</topic><topic>Fever - microbiology</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Malaria</topic><topic>Malaria - complications</topic><topic>Malaria - epidemiology</topic><topic>Malaria - microbiology</topic><topic>Malaria - virology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Respiratory tract</topic><topic>Risk factors</topic><topic>Salmonella typhi - isolation & purification</topic><topic>Salmonella typhi - physiology</topic><topic>Typhoid fever</topic><topic>Typhoid Fever - complications</topic><topic>Typhoid Fever - epidemiology</topic><topic>Typhoid Fever - microbiology</topic><topic>Vector-borne diseases</topic><topic>Waterborne diseases</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maude, Rapeephan R</creatorcontrib><creatorcontrib>Ghose, Aniruddha</creatorcontrib><creatorcontrib>Samad, Rasheda</creatorcontrib><creatorcontrib>de Jong, Hanna K</creatorcontrib><creatorcontrib>Fukushima, Masako</creatorcontrib><creatorcontrib>Wijedoru, Lalith</creatorcontrib><creatorcontrib>Hassan, Mahtab Uddin</creatorcontrib><creatorcontrib>Hossain, Md Amir</creatorcontrib><creatorcontrib>Karim, Md Rezaul</creatorcontrib><creatorcontrib>Sayeed, Abdullah Abu</creatorcontrib><creatorcontrib>van den Ende, Stannie</creatorcontrib><creatorcontrib>Pal, Sujat</creatorcontrib><creatorcontrib>Zahed, A S M</creatorcontrib><creatorcontrib>Rahman, Wahid</creatorcontrib><creatorcontrib>Karnain, Rifat</creatorcontrib><creatorcontrib>Islam, Rezina</creatorcontrib><creatorcontrib>Tran, Dung Thi Ngoc</creatorcontrib><creatorcontrib>Ha, Tuyen Thanh</creatorcontrib><creatorcontrib>Pham, Anh Hong</creatorcontrib><creatorcontrib>Campbell, James I</creatorcontrib><creatorcontrib>van Doorn, H Rogier</creatorcontrib><creatorcontrib>Maude, Richard J</creatorcontrib><creatorcontrib>van der Poll, Tom</creatorcontrib><creatorcontrib>Wiersinga, W Joost</creatorcontrib><creatorcontrib>Day, Nicholas P J</creatorcontrib><creatorcontrib>Baker, Stephen</creatorcontrib><creatorcontrib>Dondorp, Arjen M</creatorcontrib><creatorcontrib>Parry, Christopher M</creatorcontrib><creatorcontrib>Faiz, Md Abul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maude, Rapeephan R</au><au>Ghose, Aniruddha</au><au>Samad, Rasheda</au><au>de Jong, Hanna K</au><au>Fukushima, Masako</au><au>Wijedoru, Lalith</au><au>Hassan, Mahtab Uddin</au><au>Hossain, Md Amir</au><au>Karim, Md Rezaul</au><au>Sayeed, Abdullah Abu</au><au>van den Ende, Stannie</au><au>Pal, Sujat</au><au>Zahed, A S M</au><au>Rahman, Wahid</au><au>Karnain, Rifat</au><au>Islam, Rezina</au><au>Tran, Dung Thi Ngoc</au><au>Ha, Tuyen Thanh</au><au>Pham, Anh Hong</au><au>Campbell, James I</au><au>van Doorn, H Rogier</au><au>Maude, Richard J</au><au>van der Poll, Tom</au><au>Wiersinga, W Joost</au><au>Day, Nicholas P J</au><au>Baker, Stephen</au><au>Dondorp, Arjen M</au><au>Parry, Christopher M</au><au>Faiz, Md Abul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective study of the importance of enteric fever as a cause of non-malarial febrile illness in patients admitted to Chittagong Medical College Hospital, Bangladesh</atitle><jtitle>BMC infectious diseases</jtitle><addtitle>BMC Infect Dis</addtitle><date>2016-10-13</date><risdate>2016</risdate><volume>16</volume><issue>1</issue><spage>567</spage><epage>567</epage><pages>567-567</pages><artnum>567</artnum><issn>1471-2334</issn><eissn>1471-2334</eissn><abstract>Fever is a common cause of hospital admission in Bangladesh but causative agents, other than malaria, are not routinely investigated. Enteric fever is thought to be common.
Adults and children admitted to Chittagong Medical College Hospital with a temperature of ≥38.0 °C were investigated using a blood smear for malaria, a blood culture, real-time PCR to detect Salmonella Typhi, S. Paratyphi A and other pathogens in blood and CSF and an NS1 antigen dengue ELISA.
We enrolled 300 febrile patients with a negative malaria smear between January and June 2012: 156 children (aged ≤15 years) and 144 adults with a median (interquartile range) age of 13 (5-31) years and median (IQR) illness duration before admission of five (2-8) days. Clinical enteric fever was diagnosed in 52 patients (17.3 %), lower respiratory tract infection in 48 (16.0 %), non-specific febrile illness in 48 (16.0 %), a CNS infection in 37 patients (12.3 %), urinary sepsis in 23 patients (7.7 %), an upper respiratory tract infection in 21 patients (7.0 %), and diarrhea or dysentery in 21 patients (7.0 %). Malaria was still suspected in seven patients despite a negative microscopy test. S. Typhi was detected in blood by culture or PCR in 34 (11.3 %) of patients. Of note Rickettsia typhi and Orientia tsutsugamushi were detected by PCR in two and one patient respectively. Twenty-nine (9 %) patients died during their hospital admission (15/160 (9.4 %) of children and 14/144 (9.7 %) adults). Two of 52 (3.8 %) patients with enteric fever, 5/48 (10.4 %) patients with lower respiratory tract infections, and 12/37 (32.4 %) patients with CNS infection died.
Enteric fever was confirmed in 11.3 % of patients admitted to this hospital in Bangladesh with non-malaria fever. Lower respiratory tract and CNS infections were also common. CNS infections in this location merit more detailed study due to the high mortality.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>27737634</pmid><doi>10.1186/s12879-016-1886-3</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1471-2334 |
| ispartof | BMC infectious diseases, 2016-10, Vol.16 (1), p.567-567, Article 567 |
| issn | 1471-2334 1471-2334 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5064917 |
| source | MEDLINE; Springer Nature - Complete Springer Journals; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access; Springer Nature OA Free Journals |
| subjects | Adolescent Adult Aged Bangladesh - epidemiology Blood Child Child, Preschool Complications and side effects Dysentery Febrile convulsions Female Fever - etiology Fever - microbiology Hospitalization - statistics & numerical data Hospitals, University Humans Infant Infectious diseases Malaria Malaria - complications Malaria - epidemiology Malaria - microbiology Malaria - virology Male Middle Aged Respiratory tract Risk factors Salmonella typhi - isolation & purification Salmonella typhi - physiology Typhoid fever Typhoid Fever - complications Typhoid Fever - epidemiology Typhoid Fever - microbiology Vector-borne diseases Waterborne diseases Young Adult |
| title | A prospective study of the importance of enteric fever as a cause of non-malarial febrile illness in patients admitted to Chittagong Medical College Hospital, Bangladesh |
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