Multidrug-resistant typhoid fever

One hundred children (consecutive)with positive blood culture for Salmonell a typhi were studied for clinical profile and complications. The common cli nical features were fever (100%), vomiting (58%). abdominal pain (48%), cou gh (22%) and loose stools (14%) and the Widal test was positive in 75% pati ents. Eighty per cent of the salmonella isolates were resistant to amoxycil lin, chloramphenicol and co-trimoxazole drugs, but all were sensitive to ci profloxacin and ceftriaxone. Forty patients developed complications: enceph alopathy (18), melaena (12), haematemesis (10), epistaxis (4), hepatitis (4 ), acaluclous cholecystitis (4), bowel perforation (3) and nephritis (2). C omplications were more frequent in children with multidrug-resistant typhoi d. The final antibiotic required to render the children afebrile included c iprofloxacin (80), ceftriaxone, amoxycillin (4), chloramphenicol (4), amoxy cillin and gentamicin (4), amoxycillin with chloramphenicol (2), and furazo lidone (2). The defervesence time was least with ceftriaxone and greatest w ith amoxycillin. All the affected children made a complete recovery.