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 ORIGINAL ARTICLE
Year : 2008  |  Volume : 26  |  Issue : 1  |  Page : 54-57

Role of enteric fever in ileal perforations: An overstated problem in tropics?


1 Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi - 110 029, India
2 Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi - 110 029, India

Correspondence Address:
D Nair
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.38859

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Purpose: To determine the role of enteric fever in ileal perforations. Methods: A prospective cohort of 47 patients of ileal perforation was subjected to clinical examination and investigations for APACHE II scoring. Blood, ulcer edge biopsy, mesenteric lymph node and peritoneal aspirate were subjected to culture to determine the predominant aerobic bacterial isolate and its antibiogram. Results: Seven patients (14.9%) required intensive care and seven (14.9%) developed septicaemia. Mortality was 17%. Highest isolation rate was seen in ulcer edge (70.2%) followed by lymph node (66%) culture. The bacterial spectrum was Escherichia coli (23.4%), Enterococcus faecalis (21.3%), Salmonella enterica serovar Typhi (6.3%), Salmonella enterica serovar Paratyphi A (4.2%), etc. Conclusions: Enteric fever organisms are not the predominant causative agents of ileal perforations. Culture of ulcer edge biopsy, lymph node is crucial for aetiological diagnosis. The use of APACHE II triaging and prescription of antimicrobials based on the local pattern of susceptibility profile of the aetiological agent is recommended.






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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

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