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Typhoid outbreak in songkhla, Thailand 2009-2011: clinical outcomes, susceptibility patterns, and reliability of serology tests.
[typhoid]
To
determine
the
clinical
manifestations
and
outcomes
,
the
reliability
of
Salmonella
enterica
serotype
Typhi
(
S
ser
.
Typhi
)
IgM
and
IgG
rapid
tests
,
and
the
susceptibility
patterns
and
the
response
to
treatment
during
the
2009
-
2011
typhoid
outbreak
in
Songkhla
province
in
Thailand
.
T
he
medical
records
of
children
aged
<
15
years
with
S
ser
.
Typhi
bacteremia
were
analysed
.
The
efficacy
of
the
typhoid
IgM
and
IgG
rapid
tests
and
susceptibility
of
the
S
ser
.
Typhi
to
the
current
main
antibiotics
used
for
typhoid
(
amoxicillin
,
ampicillin
,
cefotaxime
,
ceftriaxone
,
co
-trimoxazole
,
and
ciprofloxacin
)
,
were
evaluated
.
S
ser
.
Typhi
bacteremia
was
found
in
368
patients
,
and
all
isolated
strains
were
susceptible
to
all
6
antimicrobials
tested
.
Most
of
the
patients
were
treated
with
ciprofloxacin
for
7
-
14
days
.
The
median
time
(
IQR
)
of
fever
before
treatment
and
duration
of
fever
after
treatment
were
5
(
4
,
7
)
days
and
4
(
3
,
5
)
days
,
respectively
.
Complications
of
ascites
,
lower
respiratory
symptoms
,
anemia
(
Hct
<
30
%
)
,
and
ileal
perforation
were
found
in
7
,
7
,
22
,
and
1
patients
,
respectively
.
None
of
the
patients
had
recurrent
infection
or
died
.
The
sensitivities
of
the
typhoid
IgM
and
IgG
tests
were
58
.
3
%
and
25
.
6
%
respectively
,
and
specificities
were
74
.
1
%
and
50
.
5
%
,
respectively
.
Most
of
the
patients
were
diagnosed
at
an
early
stage
and
treated
with
a
good
outcome
.
All
S
ser
.
Typhi
strains
were
susceptible
to
standard
first
line
antibiotic
typhoid
treatment
.
The
typhoid
IgM
and
IgG
rapid
tests
had
low
sensitivity
and
moderate
specificity
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated
