ArticleTransactions of the Royal Society of Tropical Medicine and Hygiene2022
Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever.
Article in Transactions of the Royal Society of Tropical Medicine and Hygiene, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 3 citations in OpenAlex.
- Typhoid fever.Nature reviews. Disease primers · 2023Review
- What Should We Be Recommending for the Treatment of Enteric Fever?Open forum infectious diseases · 2023Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBone marrow culture (BMC) is the reference standard for typhoid fever diagnosis. We studied the additional yield of BMC over blood culture (BC) and the relationship between quantitative BMC counts and severe disease.
methodsHospitalised Vietnamese patients with suspected typhoid fever were prospectively investigated with a BC, BMC, faecal culture and quantitative BMC counts.
resultsSalmonella typhi was isolated in 195 of 231 patients: from BC and BMC in 144 (73.8%), from BMC alone in 33 (16.9%), from BC alone in 12 (6.2%) and from faeces alone in 6 (3.1%). In 167 patients the median extracellular count of S. typhi was 2.5 cfu/mL (interquartile range [IQR] 0-10) and the intracellular count was 10.5 cfu/mL (IQR 2-42) with a ratio of 1.3 bacteria/cell (IQR 0.6-2.5). The median count of intracellular bacteria in 24 patients with severe disease was 46 bacteria/cell (IQR 9-105) compared with 6.5 bacteria/cell (IQR 2-34) in 143 with non-severe disease (p=0.005). The intracellular BMC count was negatively correlated with the peripheral white cell count and positively correlated with hepatomegaly, splenomegaly, aspartate transaminase, a positive BC and the fever clearance time following treatment with azithromycin, ofloxacin or a combination of the two.
conclusionsBMC gave a moderate additional yield over BC. Intracellular BMC counts may reflect the bacterial load in typhoid fever.
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