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Typhoid fever and typhoid hepatitis in Taiwan

Published online by Cambridge University Press:  03 May 2005

J.-L. WANG ,
J.-H. KAO ,
S.-P. TSENG ,
L.-J. TENG ,
S.-W. HO  and
P.-R. HSUEH
J.-L. WANG
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
J.-H. KAO
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
S.-P. TSENG
Affiliation:
School of Medical Technology, National Taiwan University College of Medicine, Taipei, Taiwan
L.-J. TENG
Affiliation:
School of Medical Technology, National Taiwan University College of Medicine, Taipei, Taiwan Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
S.-W. HO
Affiliation:
School of Medical Technology, National Taiwan University College of Medicine, Taipei, Taiwan Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
P.-R. HSUEH
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Abstract

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The annual incidence of typhoid fever in Taiwan was 2·1–3·6 cases per 1000000 population from 1995 to 2002. More than 80% of 45 patients with typhoid fever treated at National Taiwan University Hospital from 1996 to 2002 had elevated serum aminotransferase levels at presentation. Ten of these patients were treated during an outbreak in Taipei County in 2002, and seven of them who did not have pre-existing liver disease developed hepatitis, which was unrelated to other aetiologies. All Salmonella typhi isolates were susceptible to extended-spectrum cephalosporins and fluoroquinolones. Multidrug resistance (intermediate resistance to ampicillin, trimethoprim–sulphamethoxazole, and chloramphenicol) was found in one (2·5%) of the 40 isolates studied. Pulsed-field gel electrophoresis analysis demonstrated a high genetic diversity among S. typhi isolates and identified a novel clone associated with the 2002 outbreak. Physicians should be alert to the possibility of typhoid fever when patients, without other gastrointestinal symptoms, present with sustained fever and hepatitis.

Type
Research Article
Information
Epidemiology & Infection , Volume 133 , Issue 6 , December 2005 , pp. 1073 - 1079
Copyright
2005 Cambridge University Press