A Clinicopathological Study of Enteric Fever in Children

Enteric fever is one of the common communicable diseases affecting a large population, especially children. Despite a decrease in the incidence seen in the last few decades, it is still high on the list of disease causing significant morbidity and mortality in the developing countries.

The present study was taken up to find a clinical and laboratory profile of children suffering from typhoid fever.

The study was conducted in the Department of Pediatrics, Muzaffarnagar Medical College, Muzaffarnagar. A total of 63 inpatients children, admitted from Jan’ 2015 to Dec, 2015, with clinical diagnosis of enteric fever were enrolled in the study. Each case was subjected to a detailed history, a thorough clinical examination and the relevant laboratory tests, viz. CBC, Widal test and blood culture.

Anorexia was the most common symptom, present in three fourth of (76.2%) cases while cough was present in over half of the cases. A significant number of children had altered sensorium with a few (3.1%) showing aphasia. Speaking of the clinical signs, pallor was the most common finding, present in about two third of cases. The common type of fever was continuous and the typical step ladder pattern was not seen in any case. Another significant finding was the presence of hepatomagaly (61.9%) more frequently seen than splenomegaly (39.6%). Relative bradycardia was found only in about 12% cases, mostly in older children. While leucopenia was present only in a few cases (11.1%), the more consistent finding was eosinopenia, present in about 80% of cases with about half of all cases showing a zero eosinophil count. A positive blood culture was seen only in a few cases (3.1%), while all the cases had a positive Widal reaction.

Apart from fever, anorexia is the most common symptom. Contrary to popular belief, hepatomegaly is more frequently seen than splenomagaly. Eosinopenia is the most consistent finding with a zero eosinophil count in a substantial number of cases.