5 research outputs found
Role of enteric fever in ileal perforations: An overstated problem in tropics?
Purpose: To determine the role of enteric fever in ileal perforations.
Methods: A prospective cohort of 47 patients of ileal perforation was
subjected to clinical examination and investigations for APACHE II
scoring. Blood, ulcer edge biopsy, mesenteric lymph node and peritoneal
aspirate were subjected to culture to determine the predominant aerobic
bacterial isolate and its antibiogram. Results: Seven patients
(14.9%) required intensive care and seven (14.9%) developed
septicaemia. Mortality was 17%. Highest isolation rate was seen in
ulcer edge (70.2%) followed by lymph node (66%) culture. The bacterial
spectrum was Escherichia coli (23.4%), Enterococcus faecalis
(21.3%), Salmonella enterica serovar Typhi (6.3%), Salmonella
enterica serovar Paratyphi A (4.2%), etc. Conclusions: Enteric fever
organisms are not the predominant causative agents of ileal
perforations. Culture of ulcer edge biopsy, lymph node is crucial for
aetiological diagnosis. The use of APACHE II triaging and prescription
of antimicrobials based on the local pattern of susceptibility profile
of the aetiological agent is recommended