Typhoid Fever in Children: A Fourteen-Year Experience

在1982到1995年十四年當中，本醫學院中心有71位兒童因傷寒住院，本研究回溯分析這些病童的臨床表現、實驗室數據、治療、並發症及預俊。大多浸透病人年齡介於5到15歲之間，而發病時間以夏季及早秋居多。發燒是最常見的臨床表現，腹部症狀，包括腹痛，腹濱、惡心、嘔吐及便秘，則為其次。9名病兒(13%)有血小板低下症，此為最常見的並發症，其他並發症包括腸穿孔(3%)、腸出血(3%)、腹水或肋膜腔積水(4%)及腦膜炎(1%)。雖然沒有統計上的差異，但似乎這些並發症好發於5歲以上兒童。在多數病人對抗生素治療有應很好的反應，沒有病人死亡，但人二位病人在接受10天chloramphenicol治療後有復發的情形。分離出來的菌株對所有抗生素都有感受性，但是chloramphenicol的MIC90較其他抗生素為高。結論是，傷寒及其並發症的發生率在不同年齡層的兒童皆有不同，而目前在開發中國家嚴重的傷寒沙氏菌抗藥問題在本地區則尚未發現。

關鍵字

傷寒；傷寒沙門氏菌

並列摘要

From 1982 to 1995, 71 children admitted in our medical center were diagnosed to have typhoid fever by culture or serology. Of the 71 children, most (83%) were aged 5-15 years. These children usually presented with fever and gastrointestinal symptoms, including abdominal pain, diarrhea, nausea or vomiting, and constipation. Hepatosplenomegaly was the most common physical sign observed and abdominal tenderness ranked the second. Thrombocytopenia occurring in 9 patients (13%) was the most common mode of complication. Other complications included intestinal perforation (3%), rectal bleeding (3%), ascites or pleural effusion (4%), and meningitis (1%). The incidence of complications tended to be higher among children 5 years of age or older (p=0.31). Most patients responded well to appropriate antimicrobial therapies. There was no mortality. Relapse was observed in two children, although both had received 10 days of chloramphenicol therapy. The clinical isolates of Salmonella typhi were susceptible in vitro to all the antibiotics tested, including chloramphenicol, which, however, showed a higher MIC(subscript 90) level than other drugs tested. In conclusion, there were age-specific differences of typhoid fever in children in terms of the incidence and morbidity and antibiotic resistance of S. typhi has not been a problem in this area at least tip to 1995.

並列關鍵字

typhoid fever ； Salmonella typhi

國際替代計量

Typhoid Fever in Children: A Fourteen-Year Experience

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