Clinical Profile of Blood Culture-proven Typhoid and Paratyphoid Fever in Hospitalized Patients from a Tertiary Care Hospital in South India

Introduction: Enteric fever is an important cause of community-acquired sub-acute febrile illness, particularly in India. Over the years, improved availability of blood cultures has helped increase the number of cases diagnosed and receive appropriate treatment. Materials and Methods: A retrospective observational study on the clinical profile of hospitalized blood culture-proven enteric fever patients from October 2018 to March 2023 was done. Results: Of 125 patients, 68 (54.4%) had an infection with Salmonella typhi , and 57 patients (45.6%) with Salmonella paratyphi A. 69 (55.2%) had fever for 1–3-week duration. Among the 55 children, 32 (58.1%) had infection with S. paratyphi A and 23 (41.81%) with S. typhi . There were no life-threatening complications such as intestinal hemorrhage, perforation, or death. Seventy-seven (61.6%) of patients received ceftriaxone and azithromycin combination antibiotic therapy. Fluoroquinolone resistance was present in all the isolates (100%). Sixteen patients (12.8%) received inappropriate antibiotics before admission. Absolute eosinopenia (0%–1%) was seen in 102 (81.6%). The overall mean time to defervescence (TTD) in the study was 3.7 ± 1.3 days. The TTD was 0.7 days longer in patients presenting with fever for <7 days compared with patients with a fever of 1–3-week duration, with a statistically significant P = 0.012. Conclusions: Sending appropriate blood cultures, avoidance of inappropriate empiric antibiotic therapy, using combination antibiotic therapy, and a vaccine that protects against both S. typhi and paratyphi serotypes are some of the essential steps in reducing the burden of enteric fever.