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KMID : 0351619760170020279
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Kyungpook Medical Journal
1976 Volume.17 No. 2 p.279 ~ p.287
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Clinical Observations on Typhoid Fever in Children
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李相範/Kim, Sang Bum
金鍾煥/安斗洪/崔正憲/Kim, Jong Hwan/Ahn, Doo Hong/Choy, Chung Hun
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Abstract
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During the last 11 years from January 1953 to December 1973, clinical observation was made on 118 children who had been admitted to our department nuder the diagnosis of typhord favdr proven by positive culture and/or positive serology.
The results were obtained as follows;
1. The seasona incidence was highest during the period of June to August(50.9%) and no annual variation was noticed.
Boys were affected slightly more frequcntly than girls(55.1%) and the most frcquently affected age group was 11∼15 years of age. The youngest child affected was 4 months old infant girl.
About one third took medical advise and was admitted to the hospital within I week following the onset of the illnss and about half(56%) withio 2 weeks.
2. The most frequent complaint on admission was fever(85.6%), followed by abdomianl pain(69.5%), headache(37.3%), general malaise(36.4%), nausea and vomiting(35.6%), diarrhca(32.2%), anorexi(30.5%), cough(25.4%) and nasal bleeding(20.3%)
On the physical examination, fever(83.9%), hepatomegaly(40.7%), anemia(38.1%), dehydration(34.7%), coated tongue(33.9%), splcnomegaly and abdominal distention(25.4%), bradycardia(18.6%), abdominal tenderness(14.4%) and rose spots(11.9%) were noted in decreasing freguency.
In general, gastrointestinal disturbances were more prominent in children than adult, and bradycardia, abdominal tenderness, splenomegaly and rose spots were less marked.
3. Culture & isolation of s. typhi was positive in 24.5% from blood, 7.0% from stool and none from urine.
The widal reaction were positive in 87.41% out of total 135 tests and the frequency of positive reaction was sharply increased from the second week after onset of the illness.
Anemi was noticed in 38.2%, leukopenia in 47.46% and absolute lekopenia in 11.9%
4. The average days of defervesccnce were 4.9 days in chloramphenicol group, 3.9 days in chloramphenicol with prednisolonc group, 4.2 days in penbritin group and 5.5 days in chloramphen icol with penbritin group.
The complication was developed in 18.5%, and the most commonest one was intestinal hemorrhage(11.9%), followed by bronchitis, pneumonia, nephritis, meningitis and hepatitis etc.
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