A Clinical, Microbiological, and Pathological Study of Intestinal Perforation Associated with Typhoid Fever (original) (raw)

Journal Article

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1

Dong Thap Provincial Hospital

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Dong Thap

Reprints or correspondence: Dr. John Wain, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA, United Kingdom (jw5@sanger.ac.uk).

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Centre for Molecular Microbiology and Infection

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Imperial College

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Dong Thap Provincial Hospital

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Dong Thap

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Oxford University Clinical Research Unit

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Ho Chi Minh City, Vietnam

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Centre for Molecular Microbiology and Infection

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Imperial College

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Centre for Paediatric Gastroenterology, Royal Free and University College Medical School

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London

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Oxford University Clinical Research Unit

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Ho Chi Minh City, Vietnam

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The Hospital for Tropical Diseases

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Ho Chi Minh City, Vietnam

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Centre for Molecular Microbiology and Infection

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Imperial College

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Dong Thap Provincial Hospital

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Dong Thap

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The Hospital for Tropical Diseases

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Ho Chi Minh City, Vietnam

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Centre for Molecular Microbiology and Infection

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Imperial College

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Received:

12 September 2004

Accepted:

16 February 2005

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Nguyen Quoc Chanh, Paul Everest, Tran Tan Khoa, Deborah House, Simon Murch, Christopher Parry, Phillippa Connerton, Phan Van Bay, To Song Diep, Pietro Mastroeni, Nicholas J. White, Tran T. Hien, Vo Van Ho, Gordon Dougan, Jeremy J. Farrar, John Wain, A Clinical, Microbiological, and Pathological Study of Intestinal Perforation Associated with Typhoid Fever, Clinical Infectious Diseases, Volume 39, Issue 1, 1 July 2004, Pages 61–67, https://doi.org/10.1086/421555
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Abstract

One of the most serious complications of typhoid fever is intestinal perforation. Of 27 patients admitted to a provincial hospital in the Mekong Delta region of Vietnam who had gastrointestinal perforation secondary to suspected typhoid fever, 67% were male, with a median age of 23 years and a median duration of illness of 10 days. Salmonella enterica subspecies enterica serotype Typhi (S. Typhi) was isolated from 11 (41%) of 27 patients; of 27 patients, only 4 (15%) had positive cultures from gut biopsies. S. Typhi DNA was detected by polymerase chain reaction for all perforation biopsy samples. Detailed histological examination of the gastrointestinal mucosa at the site of perforation in all cases showed a combination of discrete acute and chronic inflammation. Acute inflammation at the serosal surface indicated additional tissue damage after perforation. Immunohistochemical results showed that the predominant infiltrating cell types at the site of perforation were CD68+ leukocytes (macrophages) or CD3+ leukocytes (T lymphocytes).

© 2004 Infectious Diseases Society of America

Topic:

• polymerase chain reaction
• biopsy
• enteric fever
• dna
• intestinal perforation
• leukocytes
• macrophages
• salmonella enterica
• t-lymphocytes
• vietnam
• inflammation, acute
• chronic inflammation
• cd68 antigen, human
• gastrointestinal perforation
• gastrointestinal mucosa
• illness length
• tissue damage
• intestinal biopsy
• serotype

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