Humans ; Panuveitis/etiology* ; Retinal Detachment/etiology* ; Typhoid Fever/diagnosis* ; Visual Acuity

Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Typhoid Fever ; diagnosis ; therapy

Anti-Bacterial Agents ; therapeutic use ; Ceftriaxone ; therapeutic use ; Child ; Conjunctival Diseases ; complications ; diagnosis ; Eye Hemorrhage ; complications ; diagnosis ; Humans ; Male ; Treatment Outcome ; Typhoid Fever ; diagnosis

BACKGROUND: Salmonella enterica serovars often have a broad host range and cause some gastrointestinal and systemic diseases. The diagnosis of typhoid fever or paratyphoid fever is made by ordinary culture methods and biochemical tests. However, a more rapid and alternative method of diagnosing these diseases is in need since the classical diagnostic method requires several days for a result. Some researchers have already reported serovar Typhi detection methods with PCR using the fliC-d gene and the Vi capsular antigen gene. METHODS: Thirty-six Salmonella strains isolated at Pusan National University Hospital from 1997 to 2004 were used for a rapid identification of S. enterica serovars Typhi and Paratyphi A with multiplex PCR that uses the O (rfbE, rfbS), H (fliC-d, fliC-a), and Vi (viaB) antigen genes. To further characterize these Salmonella strains, we used PCR to detect genes (invA and enterotoxin) for proposed virulence factors and performed antimicrobial susceptibility testing, serotyping and pulsed-field gel electrophoresis for epidemiological characteristics. RESULTS: Most strains were resistant to ampicillin. By PCR, tyv, prt, fliC-d and viaB genes were detected in serovar Typhi, whereas only fliC-a and prt genes were found in serovar Paratyphi A. In addition, invA and enterotoxin genes were detected in both strains. CONCLUSION: This method enabled us to identify and differentiate serovars Typhi and Paratyphi A by only a single PCR assay. That is, clinically important human pathogens were more rapidly and specifically detected and identified with multiplex PCR.
Ampicillin ; Busan ; Diagnosis ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxins ; Genotype ; Host Specificity ; Humans ; Multiplex Polymerase Chain Reaction* ; Paratyphoid Fever ; Polymerase Chain Reaction ; Salmonella enterica* ; Salmonella* ; Serotyping ; Typhoid Fever ; Virulence Factors

BACKGROUND: Widal test, whose sensitivity and specificity are variable from region to region depending on the incidence of typhoid fever, is still in use and shows a relatively low positive predictive value in Korea. We evaluated a rapid immunochromatographic assay (ICA) kit for the rapid diagnosis of Salmonella Typhi infection. METHODS: Twenty five patients with Salmonella Typhi bacteremia were selected for the patient group. For the control group, 21 nontyphoidal salmonellosis patients, 56 non-Salmonella bacteremia patients, and 57 healthy individuals were selected for evaluating the specificity of ICA test. Each serum specimen was tested with the SD Salmonella Typhi IgG/IgM kits (Standard Diagnostics, Inc., Yongin, Korea). RESULTS: The ICA showed a sensitivity of 100% in Salmonella Typhi patients, and specificities of 61.9%, 82.1% and 91.2% in nontyphoidal salmonellosis patients, non-Salmonella bacteremia patients, and healthy individuals, respectively. The ICA test showed a high sensitivity but a low specificity when compared with the Widal test. CONCLUSION: The ICA test by SD Salmonella Typhi IgG/IgM kit is highly sensitive, but its specificity is relatively low. The ICA test is simple, objective, and suitable for screening typhoid fever.
Bacteremia ; Diagnosis* ; Gyeonggi-do ; Humans ; Immunochromatography* ; Incidence ; Korea ; Mass Screening ; Salmonella Infections ; Salmonella typhi* ; Salmonella* ; Sensitivity and Specificity ; Typhoid Fever

BACKGROUND: Due to advances in various diagnostic methods, recent studies reported changes in the pattern of etiology of fever of unknown origin (FUO). To identify the current pattern of the causes of FUO, we analyzed the etiology of recently diagnosed FUO at a university hospital in Korea. MATERIALS AND METHODS: We reviewed 69 cases that fulfilled the criteria of classic FUO and retrospectively analyzed the etiology and decisive methods of diagnosis. RESULTS: The etioloies of FUO were infectious disease, non-infectious inflammatory disease, malignancy and miscellaneous cases in 22 (31.9%), 8 (11.6%), 4 (2.3%) and 21 (30.4%) patients, respectively. In 15 (21.7%) cases the cause could not be identified. Among infectious diseases, tuberculosis and suspected typhoid fever were the most common causes of infection (8 case, 11.7%) with tuberculosis being the most common confirmed infection. Adult onset Still's disease (13 cases, 4.4%) and drug-related fever (13 cases, 18.8%) were the most common cause of non-infectious inflammatory disease and miscellaneous causes, respectively. Decisive methods of final diagnosis were by observation of clinical course in 35 (64.8%), radiologic examination in 10 (18.5%), serologic or biochemical test in 5 (9.3%) and tissue biopsy in 4 (7.4%); none were diagnosed by culture. CONCLUSION: Infection remains the most common etiology of classic FUO in Korea and observing the clinical course is the most commonly used method for decisive diagnosis and its importance should be emphasized in approaching patients with FUO.
Adult* ; Biopsy ; Communicable Diseases ; Diagnosis ; Fever of Unknown Origin* ; Fever* ; Humans ; Korea* ; Retrospective Studies ; Still's Disease, Adult-Onset ; Tuberculosis ; Typhoid Fever

BACKGROUND: Due to advances in various diagnostic methods, recent studies reported changes in the pattern of etiology of fever of unknown origin (FUO). To identify the current pattern of the causes of FUO, we analyzed the etiology of recently diagnosed FUO at a university hospital in Korea. MATERIALS AND METHODS: We reviewed 69 cases that fulfilled the criteria of classic FUO and retrospectively analyzed the etiology and decisive methods of diagnosis. RESULTS: The etioloies of FUO were infectious disease, non-infectious inflammatory disease, malignancy and miscellaneous cases in 22 (31.9%), 8 (11.6%), 4 (2.3%) and 21 (30.4%) patients, respectively. In 15 (21.7%) cases the cause could not be identified. Among infectious diseases, tuberculosis and suspected typhoid fever were the most common causes of infection (8 case, 11.7%) with tuberculosis being the most common confirmed infection. Adult onset Still's disease (13 cases, 4.4%) and drug-related fever (13 cases, 18.8%) were the most common cause of non-infectious inflammatory disease and miscellaneous causes, respectively. Decisive methods of final diagnosis were by observation of clinical course in 35 (64.8%), radiologic examination in 10 (18.5%), serologic or biochemical test in 5 (9.3%) and tissue biopsy in 4 (7.4%); none were diagnosed by culture. CONCLUSION: Infection remains the most common etiology of classic FUO in Korea and observing the clinical course is the most commonly used method for decisive diagnosis and its importance should be emphasized in approaching patients with FUO.
Adult* ; Biopsy ; Communicable Diseases ; Diagnosis ; Fever of Unknown Origin* ; Fever* ; Humans ; Korea* ; Retrospective Studies ; Still's Disease, Adult-Onset ; Tuberculosis ; Typhoid Fever

41 children aged 7-15 years with typhoid fever (S.typhi positive blood culture) treated at Dong Thap provincial hospital from October 1999 to April 2000, were evaluated concerning the severity of the condition and the outcome of cytokine response. Results showed that the use of cytokine antibody on dissolved receptors of cytokine could have high value in severe typhoid patients. The systemic elevation of cytokine, especially IL-6 was common in children with typhoid fever and associated with the severity and the progression of the disease, high level of cytokine in hospital admission point was an important prognostic sign.
Cytokines ; Serum ; Typhoid Fever ; Child ; Diagnosis

87 children aged 7-15 years old were treated in Dong Thap General Hospital from October 1999 to April 2000 were diagnosed as typhoid fever. Patients underwent routine examinations, blood culture and bone marrow culture, and clinical care. Results showed that: Mab-based dot-blot ELISA technique for diagnosing typhoid fever on pediatric patient urine sample was a rapid technique, easy to collect sample, stable sensitivity and specificity, it could be combined with blood culture for early diagnosis of typhoid fever, especially in patients, which underwent treatment. The assay was easy to realized without complicated equipment, and easy to observe the result.
Diagnosis ; Typhoid Fever ; Child

PURPOSE: This study was performed to find the clinical significance in protein C as a differential marker in the beginning stage of infection and prognosis factor in severe infection among pediatric patients who were admitted due to fever. METHODS: A total of 40 pediatric patients who had temperatures higher than 37.5degrees C on admission at the Department of Pediatrics, Chungnam National University between December, 2002 and August, 2003 were enrolled. Total white blood cell count(WBC), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and protein C were performed for those patients on admission. Clinical progress, diagnosis and prognosis were reviewed for these patients. The 40 patients were divided into two groups based on the diagnosis of bacterial and nonbacterial infections. RESULTS: Twenty patients(50%) were suspected of bacterial infections that showed positive results in blood, sputum, urine, and spinal cord fluid. There were eight cases with bacterial pneumonia, five with urinary tract infection, four with bacterial meningitis, two with cellulitis, and one with typhoid fever. The remaining 20 patients were diagnosed with nonbacterial infections because they had negative results in blood cultures. ESR and CRP were increased beyond normal range in both groups. However, protein C was significantly decreased in the bacterial infection group and yet normal range in the nonbacterial infection group(P<0.05). CONCLUSION: Protein C can be used as a differential marker in order to distinguish between bacterial and nonbacterial infections. In addition, protein C can possibly be used as a prognostic factor that can predict severe infection.
Bacterial Infections* ; Blood Sedimentation ; Cellulitis ; Chungcheongnam-do ; Diagnosis ; Fever* ; Humans ; Leukocytes ; Meningitis, Bacterial ; Pediatrics ; Pneumonia, Bacterial ; Prognosis ; Protein C* ; Reference Values ; Spinal Cord ; Sputum ; Typhoid Fever ; Urinary Tract Infections