Patients with
typhoid or
paratyphoid fever, admitted to 14 hospitals for
infectious diseases during 1984-1987, were epidemically and clinically studied. Of the total number of 183
typhoid, 49
paratyphoid fever patients, those infected overseas was 44.3% and 71.4% respectively, giving an overall annual decrease, yet marking an increased ratio of overseas
infection. Patients aged 20s-30s and males were dominant. One hundred and seventy six cases (96.2%) of
typhoid and all the
paratyphoid fever cases were bacteriologically diagnosed. The period from the onset to the diagnosis was around 14 days in most cases, but beyond 29 days in over 10% of the cases. We would like to emphasize that
enteric fever, focusing on high
fever,
bradycardia, roseola, hepatosplenomegaly,
leukopenia, elevated serum-GOT GPT and LDH, can be easily diagnosed by blood/stool culture before beginning
chemotherapy. Intestinal
bleeding was recognized in 24 cases (13.1%) of
typhoid and 4 (8.2%) of
paratyphoid fever,
intestinal perforation in 2 (1.1%) and death in 1 (0.5%) of
typhoid fever. CP was most commonly used in
chemotherapy. Bacteriological relapse was recognized in 7/127 cases (5.5%) of
typhoid, 6/48 (13.0%) of
paratyphoid fever those followed beyond 3 weeks, though eradication was attained by
retreatment. One strain of S. typhi resistant to CP.ABPC.KM.SM was isolated in 1986 from a patient infected overseas. New
quinolones seem reliable in our preliminary studies.