A clinical, microbiological, and pathological study of intestinal perforation associated with typhoid fever

Nguyen Quoc Chanh; Paul Everest; Tran Tan Khoa; Deborah House; Simon Murch; Christopher Parry; Phillippa Connerton; Phan Van Bay; To Song Diep; Pietro Mastroeni; Nicholas J. White; Tran T. Hien; Vo Van Ho; Gordon Dougan; Jeremy J. Farrar; John Wain

doi:10.1086/421555

A clinical, microbiological, and pathological study of intestinal perforation associated with typhoid fever

Nguyen Quoc Chanh, Paul Everest, Tran Tan Khoa, Deborah House, Simon Murch, Christopher Parry, Phillippa Connerton, Phan Van Bay, To Song Diep, Pietro Mastroeni, Nicholas J. White, Tran T. Hien, Vo Van Ho, Gordon Dougan, Jeremy J. Farrar, John Wain

Norwich Medical School

Research output: Contribution to journal › Article › peer-review

60 Citations (Scopus)

Abstract

One of the most serious complications of typhoid fever is intestinal perforation. Of 27 patients admitted to a provincial hospital in the Mekong Delta region of Vietnam who had gastrointestinal perforation secondary to suspected typhoid fever, 67% were male, with a median age of 23 years and a median duration of illness of 10 days. Salmonella enterica subspecies enterica serotype Typhi (S. Typhi) was isolated from 11 (41%) of 27 patients; of 27 patients, only 4 (15%) had positive cultures from gut biopsies. S. Typhi DNA was detected by polymerase chain reaction for all perforation biopsy samples. Detailed histological examination of the gastrointestinal mucosa at the site of perforation in all cases showed a combination of discrete acute and chronic inflammation. Acute inflammation at the serosal surface indicated additional tissue damage after perforation. Immunohistochemical results showed that the predominant infiltrating cell types at the site of perforation were CD68+ leukocytes (macrophages) or CD3+ leukocytes (T lymphocytes).

Original language	English
Pages (from-to)	61-67
Number of pages	7
Journal	Clinical Infectious Diseases
Volume	39
Issue number	1
DOIs	https://doi.org/10.1086/421555
Publication status	Published - 1 Jul 2004

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10.1086/421555

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Chanh, N. Q., Everest, P., Khoa, T. T., House, D., Murch, S., Parry, C., Connerton, P., Van Bay, P., Diep, T. S., Mastroeni, P., White, N. J., Hien, T. T., Van Ho, V., Dougan, G., Farrar, J. J., & Wain, J. (2004). A clinical, microbiological, and pathological study of intestinal perforation associated with typhoid fever. Clinical Infectious Diseases, 39(1), 61-67. https://doi.org/10.1086/421555

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title = "A clinical, microbiological, and pathological study of intestinal perforation associated with typhoid fever",

abstract = "One of the most serious complications of typhoid fever is intestinal perforation. Of 27 patients admitted to a provincial hospital in the Mekong Delta region of Vietnam who had gastrointestinal perforation secondary to suspected typhoid fever, 67% were male, with a median age of 23 years and a median duration of illness of 10 days. Salmonella enterica subspecies enterica serotype Typhi (S. Typhi) was isolated from 11 (41%) of 27 patients; of 27 patients, only 4 (15%) had positive cultures from gut biopsies. S. Typhi DNA was detected by polymerase chain reaction for all perforation biopsy samples. Detailed histological examination of the gastrointestinal mucosa at the site of perforation in all cases showed a combination of discrete acute and chronic inflammation. Acute inflammation at the serosal surface indicated additional tissue damage after perforation. Immunohistochemical results showed that the predominant infiltrating cell types at the site of perforation were CD68+ leukocytes (macrophages) or CD3+ leukocytes (T lymphocytes).",

author = "Chanh, {Nguyen Quoc} and Paul Everest and Khoa, {Tran Tan} and Deborah House and Simon Murch and Christopher Parry and Phillippa Connerton and {Van Bay}, Phan and Diep, {To Song} and Pietro Mastroeni and White, {Nicholas J.} and Hien, {Tran T.} and {Van Ho}, Vo and Gordon Dougan and Farrar, {Jeremy J.} and John Wain",

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Chanh, NQ, Everest, P, Khoa, TT, House, D, Murch, S, Parry, C, Connerton, P, Van Bay, P, Diep, TS, Mastroeni, P, White, NJ, Hien, TT, Van Ho, V, Dougan, G, Farrar, JJ & Wain, J 2004, 'A clinical, microbiological, and pathological study of intestinal perforation associated with typhoid fever', Clinical Infectious Diseases, vol. 39, no. 1, pp. 61-67. https://doi.org/10.1086/421555

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AU - Chanh, Nguyen Quoc

AU - Everest, Paul

AU - Khoa, Tran Tan

AU - House, Deborah

AU - Murch, Simon

AU - Parry, Christopher

AU - Connerton, Phillippa

AU - Van Bay, Phan

AU - Diep, To Song

AU - Mastroeni, Pietro

AU - White, Nicholas J.

AU - Hien, Tran T.

AU - Van Ho, Vo

AU - Dougan, Gordon

AU - Farrar, Jeremy J.

AU - Wain, John

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N2 - One of the most serious complications of typhoid fever is intestinal perforation. Of 27 patients admitted to a provincial hospital in the Mekong Delta region of Vietnam who had gastrointestinal perforation secondary to suspected typhoid fever, 67% were male, with a median age of 23 years and a median duration of illness of 10 days. Salmonella enterica subspecies enterica serotype Typhi (S. Typhi) was isolated from 11 (41%) of 27 patients; of 27 patients, only 4 (15%) had positive cultures from gut biopsies. S. Typhi DNA was detected by polymerase chain reaction for all perforation biopsy samples. Detailed histological examination of the gastrointestinal mucosa at the site of perforation in all cases showed a combination of discrete acute and chronic inflammation. Acute inflammation at the serosal surface indicated additional tissue damage after perforation. Immunohistochemical results showed that the predominant infiltrating cell types at the site of perforation were CD68+ leukocytes (macrophages) or CD3+ leukocytes (T lymphocytes).

AB - One of the most serious complications of typhoid fever is intestinal perforation. Of 27 patients admitted to a provincial hospital in the Mekong Delta region of Vietnam who had gastrointestinal perforation secondary to suspected typhoid fever, 67% were male, with a median age of 23 years and a median duration of illness of 10 days. Salmonella enterica subspecies enterica serotype Typhi (S. Typhi) was isolated from 11 (41%) of 27 patients; of 27 patients, only 4 (15%) had positive cultures from gut biopsies. S. Typhi DNA was detected by polymerase chain reaction for all perforation biopsy samples. Detailed histological examination of the gastrointestinal mucosa at the site of perforation in all cases showed a combination of discrete acute and chronic inflammation. Acute inflammation at the serosal surface indicated additional tissue damage after perforation. Immunohistochemical results showed that the predominant infiltrating cell types at the site of perforation were CD68+ leukocytes (macrophages) or CD3+ leukocytes (T lymphocytes).

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