Cardiac status in typhoid fever.

Fifty adult patients with culture-proved typhoid fever were subjected to daily clinical, electrocardiographic (ECG), and electrolyte assessment to evaluate and correlate their cardiac status. Transaminases and creatine kinase (CCK-MB) were estimated on alternate days and echocardiographic assessment was done once during hospitalization. The patients were distributed into groups: I (21) who did not have any ECG or enzymes changes, IIa (17) who had both ECG as well as enzymes changes, IIb (5) who had ECG changes only, and IIc (7) who had elevated enzymes only. Various types of ECG abnormalities were observed in 22 patients. Transaminases were significantly raised (P < 0.001) in group IIa and IIc patients (24). However, CK-MB was significantly raised (P < 0.001) only in the 5 patients of group IIa. There was no relationship among the elevated enzyme levels, severity of disease, and ECG changes. Further, ECG changes were observed during the convalescence stage also, but transaminases were found to be elevated only during the acute stage. It is concluded that definite injury to the heart occurs during typhoid fever. However, it is difficult to ascertain the exact time and extent of the injury. Further, CK-MB was not found to be superior to transaminases for assessment.