[Typhoid and paratyphoid fever in children].

BACKGROUND

Febrile illness without focal symptoms in a child who has visited tropical or sub-tropical areas is an increasing health problem in western countries. In the department of paediatrics at Ullevaal University Hospital, malaria, typhoid and paratyphoid fever are the most frequent infectious diseases acquired in tropical or sub-tropical areas.

MATERIALS AND

METHODS

We describe all 31 children under 16 admitted between 1998 and 2003 who had blood cultures positive for Salmonella typhi or Salmonella paratyphi A or B.

RESULTS

Nearly all the children were second or third generation immigrants from the Indian subcontinent. Fever was the main symptom at onset. Out of 31 salmonella strains, 8 showed reduced sensitivity to quinolones, which are the drugs of choice. Clinical poor response to treatment is associated with reduced sensitivity to nalidixic acid in vitro.

CONCLUSION

Blood cultures prior to administration of antibiotics are important in providing correct diagnosis and appropriate treatment. Before visiting endemic areas, groups at risk should be informed that there are vaccines available against typhoid fever.