Clinical Diagnosis Of Enteric Fever And The Potential Benefits In The Management Of Enteric Fevers In The Developing World

Aim To examine the clinical presentations of enteric fever so as to aid their quick clinical diagnosis. Methods A systematic literature review on clinical presentations of enteric fever was carried out. Relevant information from original articles, reviewed articles, short communications, letters to the editor, and case reports over a 30 year period (1977-2007) were compiled. Data obtained was analysed using simple descriptive methods. Results Fever, headache, weakness, chills, anorexia, and fatigue were the most frequent symptoms encountered among patients with enteric fever. Also bradycardia, low blood pressure, weight loss, hepatomegaly and splenomegaly, and coated tongue were among the most frequent signs encountered among similar patients. Laboratory findings based on isolation of Salmonella spp. from specimens as well as significant titres in widal test could be used to establish diagnosis of enteric fever. Clinical presentations such as meningitis, myocarditis, splenic/hepatic abscess, psoas abscess, dysentery, haemorrhagic cystitis, pneumonia, glomerulonephritis and acute aphasia were found to be among the unexpected and unusual presentations of enteric fever. Conclusion In view of the diverse and complex presentations of typhoid fever, physicians should approach patients with infective, psychiatric and neurologic clinical features with the belief that, Salmonella infection may not be that remote a possibility.