Clinical profile and liver function assessment in children with typhoid fever

Background. Typhoid fever is still a major health problem in developing countries, with significant morbidity and mortality. The disease can lead to liver damage if not adequately treated. Liver involvement is known in typhoid fever in the form of clinical, biochemical, and histopathological changes. This study aims to assess the liver function changes on the first, second, and third weeks in children with typhoid fever and evaluate their clinical presentation and complications throughout the disease course. Materials and methods. This is a hospital-based descriptive study from October 2023 to August 2024 in Al-Zahraa Teaching Hospital for Maternity and Children in Al-Najaf City. We enrolled 43 children (27 male and 16 female) aged 1–12 years with typhoid fever diagnosed by clinical feature plus positive serology or blood culture. The study was designed to include clinical information, complications, and changes in liver function in each patient. Results. In this study, there were 19 children aged 1–5 years (44.2%) and 24 (55.8 %) cases between 6 and 12 years, males outnumbered females (62.8 vs 37.2 %). All patients presented with fever, 25 (58.1 %) with anorexia, 22 (51.2 %) with abdominal pain, 17 (39.5 %) with headache, 14 (32.6 %) with vomiting, and other symptoms were less frequent. Regarding signs, most patients had hepatomegaly — 19 (44.2 %), 12 (27.9 %) were toxic looking, abdominal tenderness was detected in 10 (23.3 %) children, splenomegaly in 7 (16.3 %), edema in 2 (4.7 %), jaundice in 2 (4.7 %), and only 1 (2.3 %) patient had skin rash. We reported hepatitis in 2 cases (4.7 %), intestinal perforation in other 2 (4.7 %), one patient had endocarditis (2.3 %) and another one Guillain-Barre syndrome (2.3 %). The parameters of liver function tests that were significantly affected through the disease course were total serum protein (p < 0.001) and serum albumin (p < 0.001). Conclusions. Typhoid fever was more common among males than females and more common in children aged 6–12. It causes various enzymatic and biochemical changes, including mild liver enzyme derangement and significant changes in total serum protein and serum albumin, which may be used as laboratory parameters for follow-up patients with typhoid fever.