Epidemiology and Infection

Table of Contents - 2005 - Volume 133, Issue 06  


Typhoid fever and typhoid hepatitis in Taiwan

J.-L. WANG a1, J.-H. KAO a1, S.-P. TSENG a2, L.-J. TENG a2a3, S.-W. HO a2a3 and P.-R. HSUEH a1a3c1
a1 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
a2 School of Medical Technology, National Taiwan University College of Medicine, Taipei, Taiwan
a3 Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan

Article author query
wang jl   [PubMed][Google Scholar] 
kao jh   [PubMed][Google Scholar] 
tseng sp   [PubMed][Google Scholar] 
teng lj   [PubMed][Google Scholar] 
ho sw   [PubMed][Google Scholar] 
hsueh pr   [PubMed][Google Scholar] 

Abstract

The annual incidence of typhoid fever in Taiwan was 2·1–3·6 cases per 1000000 population from 1995 to 2002. More than 80% of 45 patients with typhoid fever treated at National Taiwan University Hospital from 1996 to 2002 had elevated serum aminotransferase levels at presentation. Ten of these patients were treated during an outbreak in Taipei County in 2002, and seven of them who did not have pre-existing liver disease developed hepatitis, which was unrelated to other aetiologies. All Salmonella typhi isolates were susceptible to extended-spectrum cephalosporins and fluoroquinolones. Multidrug resistance (intermediate resistance to ampicillin, trimethoprim–sulphamethoxazole, and chloramphenicol) was found in one (2·5%) of the 40 isolates studied. Pulsed-field gel electrophoresis analysis demonstrated a high genetic diversity among S. typhi isolates and identified a novel clone associated with the 2002 outbreak. Physicians should be alert to the possibility of typhoid fever when patients, without other gastrointestinal symptoms, present with sustained fever and hepatitis.

(Published Online May 3 2005)
(Accepted January 27 2005)


Correspondence:
c1 Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan. (Email: hsporen@ha.mc.ntu.edu.tw)

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