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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Identification of typhoid fever and paratyphoid fever cases at presentation in outpatient clinics in Jakarta, Indonesia.
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Identification of typhoid fever and paratyphoid fever cases at presentation in outpatient clinics in Jakarta, Indonesia.

机译：在印度尼西亚雅加达的门诊就诊时鉴定伤寒和副伤寒病例。

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In Jakarta, Indonesia, over 80% of patients with typhoid fever or paratyphoid fever are treated in outpatient settings. In a community-based prospective passive surveillance study, we identified 59 typhoid, 23 paratyphoid fever and 259 non-enteric fever outpatients, all blood culture-confirmed. We compared their symptoms with the aim of developing a clinical prediction rule that may help direct empirical antibiotic treatment to cases with suspected (para)typhoid fever, rather than all febrile patients, or refer patients for additional diagnostic tests. Paratyphoid fever (Salmonella paratyphi A) could not be distinguished clinically from typhoid fever. Decisions on empirical antibiotic treatment and advice on hygiene measures in patients with suspected (para)typhoid fever should take into account chills and absence of cough in the first week of fever and delirium in the second week of illness. This prediction rule increases the likelihood of (para)typhoid fever from 1:10 in the first week to, at most, 2:3 in the second week of a febrile illness. However, we were not able to propose a robust clinical prediction rule that could be used as absolute screening method for decisions on additional diagnostic tests, because of the low sensitivity of presenting symptoms in (para)typhoid fever.
机译：在印度尼西亚雅加达，超过80％的伤寒或副伤寒患者在门诊接受治疗。在一项基于社区的前瞻性被动监测研究中，我们确定了59例伤寒，23例副伤寒和259例非肠胃热门诊患者，所有患者均经血培养证实。我们比较了他们的症状，目的是制定临床预测规则，该规则可能有助于将经验性抗生素治疗直接用于可疑（副）伤寒的病例，而不是所有高热患者，或转诊患者进行其他诊断测试。临床上无法将伤寒（副伤寒沙门氏菌）与伤寒区分开。对疑似（副）伤寒患者进行经验性抗生素治疗的决定和卫生措施的建议，应考虑到发烧的第一周发冷，咳嗽，第二周出现week妄。这种预测规则将（副）伤寒的可能性从高热疾病的第一周的1:10增加到第二周的最多2：3。但是，由于（副）伤寒症状的敏感性较低，因此我们无法提出可作为绝对筛查方法进行其他诊断检查的可靠的临床预测规则。

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