COMPARISON OF CLINICAL-FEATURES AND PATHOLOGICAL FINDINGS IN FATAL CASES OF TYPHOID-FEVER DURING THE INITIAL AND LATER STAGES OF THE DISEASE

This study was undertaken to correlate the clinical features and patho logic changes noted during the initial and later stages of fatal typho id illness. Five cases who died during the initial stage of the illnes s (< 2 weeks from onset) had altered mental status, tachypnea, and tac hycardia. Three had shock and elevation of serum creatinine values. Au topsies of all five revealed hyperplastic Peyer's patches, features of adult respiratory distress syndrome, and megakaryocytosis. Five other cases died during the later stage of the illness (greater than or equ al to 2 weeks after onset). They had a left shift in peripheral blood leukocyte count. Autopsies revealed deep ileal ulcerations with or wit hout perforation and peritonitis and intercurrent pneumonia. Three of them had disseminated intravascular coagulation. Further studies are w arranted to understand the mediators of shock and tissue injuries duri ng the initial period of the illness.