الفهرس | Only 14 pages are availabe for public view |
Abstract Typhoid fever is a multisystemic infectious disease that affects different organs in a variable degrees. Typhoid fever is a world wide in distribution. In Egypt, typhoid fever still more prevelant disease specially in the summar monthes and this is due to bad habit of eating outside home. We tried to assess hepatic affection in children with typhoid fever because of recently reported cases were presenting with hepatitis, like picture in typhoid fever. In the present study 55 children with typhoid fever were admitted to Tanta Fever Hospital for diagnosis and management. they were 31 males and 24 females, their ages ranged from 3-12 y. All cases were subjected to full history-tacking, clinical examination. routine investigation, serological , liver function tests and liver ultrasound. Excluding the presence of viral hepatitis • bilharziasis, gall stone, other coexistent disease and antibiotic or drug abuse that may affects liver function. The evolution time of the disease was considered from the onset of the first symptoms usually fever and children were divided into two groups : Group I: Being those in the 1st. week Group II: Those in the 2nd . or 3rd. week from the onset. It was found that fever, headach abdominal pain, coated tongue, bowel habit disturbances, splenomegaly and hepatomegaly were the most commonly encountered features. Hepatomegaly was found durtng the 2nd or 3rd. week more often than in the 1st week (57.14% VS. 20%). No clinical features suggestive of hepatitis were seen among our cases. This denotes that although typhoid hepatitis is common, yet clinically manifestated cases are rare. Bilirubin, alkaline phosphatase, SGPT, SGOT and prothrombin time were raised in 37% , 45.7%,51.4%, 20% and 42.8% of our cases respectively during the 2nd and 3rd week of illness. Summaru & Condusion. CONCLUSION AND RECOMMENDATION In conclusion, although the clincial picture of hepatitis is unusual. in typhoid fever, the liver involvement is invariably present after the 1st. week of illness and directly proportional with widal ”0” titre. The liver involvement in typhoid fever is considered as a complication but it is not a life threatining complication of S. typhi infection. Furthere longer prospective studies are recommended to asses the sequale of liver dysfunction in typhoid fever and to determine its pathogenesis. S. typhi should however be added to the list of pathogens implicated in the pathogenesis of infectious hepatitis and should considered in the differential diagnosis. We recommended hepatic function evaluation in all cases of typhoid fever, as well as, the follow up of liver function for prognostic value. |