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J Infect. 2010 Feb;60(2):91-8. doi: 10.1016/j.jinf.2009.11.009. Epub 2009 Dec 3.

Enteric fever in a UK regional infectious diseases unit: a 10 year retrospective review.

Author information

1
Infectious diseases Unit, Level 6 Windsor building, Leicester Royal Infirmary, Leicester LE15WW, UK. tristan.w.clark@uhl-tr.nhs.uk

Abstract

INTRODUCTION:

Enteric fever is an increasingly common diagnosis in returning travellers in the UK.

METHODS:

We performed a retrospective descriptive study of culture-confirmed cases of enteric fever admitted to University Hospitals Leicester, UK between January 1999 and April 2009.

RESULTS:

100 cases of enteric fever were identified in adults (n = 76) and children (n = 24). The median age of adult subjects was 38 (range 18-71) and 55% were male. Of the 61 adult cases with notes available, 60 (98.3%) were of Asian ethnicity and 56 (92%) had a recent travel history, principally to the Indian Subcontinent. Symptoms included fever (100%), headache (62%), diarrhoea (59%) and abdominal pain (44%). Common examination findings included pyrexia and mild generalized abdominal tenderness. Mild hyponatraemia, transaminitis and a normal white cell count were commonly identified. Reduced ciprofloxacin sensitivity was common and increased over the study period. Median fever clearance time was 6 days, and treatment failure occurred in 20% of cases. Relapse occurred in 2 patients. Complications were unusual, and one patient died.

DISCUSSION:

Patients with enteric fever presented with a non-specific febrile illness within one month after returning from travel, and most had an uncomplicated clinical course. Increasing ciprofloxacin insensitivity was the likely explanation for a high treatment failure rate and this agent can no longer recommended as empirical treatment.

PMID:
19962402
DOI:
10.1016/j.jinf.2009.11.009
[Indexed for MEDLINE]

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