Haematological Profile in Typhoid Fever

Khosla, Shivun; Anand, A C; Singh, Uma; Khosla, Amit

doi:10.1177/004947559502500404

Cited by 39 publications

(52 citation statements)

References 10 publications

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“…Leucopenia, thrombocytopenia and anemia in typhoid can be attributed to the myeloid maturation arrest, decrease in the number of erythroblasts and megakaryocytes and increased phagocytic activity of histiocytes in the bone marrow. 10 In this study, 80% (40) had typhoid fever and 20% (10) patients had paratyphoid fever on the basis of significant Widal titers and isolation of Salmonella in blood culture. In a similar study done by Krishnan P et al in Chennai, 70% of isolates were Salmonella typhi and 30% were Salmonella paratyphi A, which was in accordance with our study.…”

Section: Resultsmentioning

confidence: 65%

Clinical profile of enteric fever: a prospective study of fifty enteric fever patients

2014

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Section: Resultsmentioning

confidence: 65%

Clinical profile of enteric fever: a prospective study of fifty enteric fever patients

2014

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“…This cell type distinction is of clinical significance because it affects diagnosis and treatment (10). Whether macrophages, dendritic cells, or neither predominates in human typhoid fever is not clear because distinguishing markers have not been examined (17,34). To establish the identity of hemophagocytic cells in murine typhoid fever, spleen cells were dissociated and incubated with antibodies to cell-type-specific markers.…”

Section: Resultsmentioning

confidence: 99%

“…This has potential clinical importance, as human hemophagocytic diseases are diagnosed and treated based on whether they are dominated by dendritic cells (e.g., Langerhans cell histiocytosis) or macrophages (e.g., hemophagocytic lymphohistiocytosis [HLH], or MAS) (10,13). Whether hemophagocytosis in typhoid fever patients is macrophage or dendritic cell related is not clear (17,34). Given that markers distinguishing between human macrophages and dendritic cells now exist, this issue could be revisited in bone marrow biopsy samples from confirmed typhoid patients.…”

Section: Discussionmentioning

confidence: 99%

“…At that time, macrophages and dendritic cells were not recognized as distinct cell types. More recent studies have confirmed the presence of hemophagocytes within the bone marrow of typhoid fever patients, but the identity of these cells has not been established with celltype-specific markers (17,34). Whether the hemophagocytes of typhoid fever are macrophages, dendritic cells, or both is of potential clinical significance, because histiocytoses are currently classified and treated based on the origin of the histiocytes (10).…”

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confidence: 99%

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Hemophagocytic Macrophages in Murine Typhoid Fever Have an Anti-Inflammatory Phenotype

2012

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Histiocytes are white blood cells of the monocytic lineage and include macrophages and dendritic cells. In patients with a variety of infectious and noninfectious inflammatory disorders, histiocytes can engulf nonapoptotic leukocytes and nonsenescent erythrocytes and thus become hemophagocytes. We report here the identification and characterization of splenic hemophagocytes in a natural model of murine typhoid fever. The development of a flow-cytometric method allowed us to identify hemophagocytes based on their greater than 6N (termed 6N؉) DNA content. Characterization of the 6N؉ population from infected mice showed that these cells consist primarily of macrophages rather than dendritic cells and contain T lymphocytes, consistent with hemophagocytosis. Most 6N؉ macrophages from Salmonella enterica serovar Typhimurium-infected mice contain intact DNA, consistent with hemophagocytosis. In contrast, most 6N؉ macrophages from control mice or mice infected with a different bacterial pathogen, Yersinia pseudotuberculosis, contain damaged DNA. Finally, 6N؉ splenic macrophages from S. Typhimuriuminfected mice express markers consistent with an anti-inflammatory M2 activation state rather than a classical M1 activation state. We conclude that macrophages are the predominant splenic hemophagocyte in this disease model but not in Y. pseudotuberculosis-infected mice. The anti-inflammatory phenotype of hemophagocytic macrophages suggests that these cells contribute to the shift from acute to chronic infection.

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“…In an etiological study of pancytopenia in children, around 30% of patients with infections as a cause for pancytopenia had enteric fever [7]. The bone marrow suppression is believed to be due to a maturity arrest of the myeloid series, erythroblasts and megakaryocytes and excessive phagocytic activity of the histiocytes in the marrow [8].…”

Section: Discussionmentioning

confidence: 99%

Profile of Culture Positive Enteric Fever from Bangalore

Gupta

Handa

Chadha

et al. 2009

Medical Journal Armed Forces India

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Background: Enteric fever is endemic in India. The aim of this study was to analyse the clinical, laboratory, antibiotic sensitivity profile and response to antibiotics of culture positive enteric fever patients from Bangalore. Methods: In this retrospective study only culture positive enteric fever patients were taken and their clinical, laboratory, antibiotic sensitivity profile and the clinical response to antibiotics studied. Result: Eighty one culture positive enteric fever patients were taken into the study. Presenting symptoms included fever, pain abdomen (18.5%), loose stools (25%), vomiting (33%) and headache (30%). Absolute bradycardia at admission was not found in any of our patients. Normal or low total leucocyte count was seen in 97.5%. Typhoid hepatitis was seen in 8.5%. Salmonella enterica subspecies enterica serovar typhi (S typhi) were isolated in 80% of cases; 83% of all cases showed nalidixic acid resistance. All isolates were sensitive to chloramphenicol and third generation cephalosporins. Ciprofloxacin resistance was found in 19% cases. The time to defervescence in patients treated with ceftriaxone was 4.3 days. There was no statistical difference in time to defervescence in nalidixic acid resistant and sensitive strains. Complications included gastro intestinal bleed and encephalopathy. Conclusion: Prevalence of nalidixic acid resistance is high, while clinical resistance to quinolones may be higher than that found in the laboratory which requires detailed study. Chloramphenicol sensitivity has returned and nalidixic acid resistant and sensitive isolates are uniformly sensitive to third generation cephalosporins with no difference in time to defervescence. MJAFI 2009; 65 : 328-331

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Haematological Profile in Typhoid Fever

Cited by 39 publications

References 10 publications

Clinical profile of enteric fever: a prospective study of fifty enteric fever patients

Clinical profile of enteric fever: a prospective study of fifty enteric fever patients

Hemophagocytic Macrophages in Murine Typhoid Fever Have an Anti-Inflammatory Phenotype

Profile of Culture Positive Enteric Fever from Bangalore

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