SONOGRAPHIC ANALYSIS OF GALLBLADDER FINDINGS IN SALMONELLA ENTERIC FEVER

The purpose of this study was to analyze gallbladder sonographic findi ngs associated with Salmonella typhi enteric fever. Sixty-two patients with culture positive Salmonella enteric fever were analyzed with ser ial sonography. The following gallbladder sonographic findings were no ted: globular gallbladder distention (33 of 62 patients, 53%), positiv e sonographic Murphy sign (25 patients, 40%), pericholecystic edema or fluid (25 patients, 40%), gallbladder wall thickening > 4 mm (21 pati ents, 34%), low-level nonshadowing intraluminal echoes or sludge (nine patients, 15%) intramural linear sonolucency or striation (eight pati ents, 13%), and mucosal irregularity or sloughed membrane (four patien ts, 6%). Using the sonographic findings a gallbladder score was devise d to assess the severity of gallbladder changes, and the score was cor related with the following clinical parameters-duration of fever, mult idrug resistance, and clinical outcome. An abnormal gallbladder score was noted in 37 patients (60%), and multidrug resistance was noted in 35 of these patients (95%). The gallbladder scores showed a strong pos itive correlation with the duration of fever and the frequency of mult idrug resistance. All 62 patients were treated with intensive antibiot ic therapy without any deaths.