MOHAMMED FATHY ABDEL WAHAB, M.B.; R. PAUL ROBERTSON; FRANK O. RAASCH
Paratyphoid A fever was studied in 41 adolescent parents who had been febrile approximately 1 week before admission and only 1 of whom had ever been immunized with a salmonella vaccine. Clinical evaluation agreed with the classical description of paratyphoid fever except for a scarcity of rose spots. Leukocyte counts and Widal reactions afforded minimal diagnostic aid, but bone marrow and multiple blood cultures were valuable. Seven patients were concomitantly infected with Schistosoma species, but this did not influence their clinical courses. In vitro, Salmonella paratyphi A strains were generally more sensitive to ampicillin than to chloramphenicol. Chloramphenicol, ampicillin, and both drugs given simultaneously were used in treatment. The mean afebrile days of the respective drug groups were 5.0, 5.8, and 5.9. There was a 21% treatment failure rate with ampicillin, an 8% relapse rate with chloramphenicol, but no therapeutic shortcomings in the combined-therapy group. Steroids were needed in only one instance, and there were no complications, deaths, or development of the carrier state.
WAHAB MFA, ROBERTSON RP, RAASCH FO. Paratyphoid A Fever. Ann Intern Med. 1969;70:913–917. doi: 10.7326/0003-4819-70-5-913
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Published: Ann Intern Med. 1969;70(5):913-917.
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