[afro-nets] Open Learning Web site on Enteric pathogens

["Salvatore Rubino" <rubino@uniss.it>]

Open Learning Web site on Enteric pathogens
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Dear Friends of the Open Learning Web site on Enteric pathogens

A new lecture is available at the new web site  <http://www.oloep.org/>www.oloep.org

A simple validated prediction rule to diagnose typhoid fever in Turkey

Salih Hosoglu,
Dicle University Hospital, Diyarbakir, Turkey


In endemic areas, typhoid fever may mimic many common infectious and non-infectious diseases. The differential diagnosis of typhoid fever includes brucellosis, viral meningitis/encephalitis, tuberculosis, bacterial pneumonia, leptospirosis, malaria, bacteremia/sepsis, tularemia, rickettsial diseases, dengue fever, acute hepatitis, infectious mononucleosis, leishmaniasis, amebiasis, urinary tract infection, upper viral respiratory infection and adult-onset Still's disease. The symptoms and signs of uncomplicated typhoid fever, such as fever, headache, abdominal discomfort, constipation, or diarrhea, are nonspecific. Making a timely and precise diagnosis is therefore an important challenge to clinicians.

The goal of this study was to develop a simple prediction rule for the diagnosis of typhoid fever. A model for the prediction of patients with typhoid fever at hospital admission was derived and validated by assigning weighted point values to independent predictive factors associated with a diagnosis of typhoid fever at hospital admission. Patient demographic, clinical and laboratory variables were used to compare patients with blood culture-confirmed typhoid fever with patients with fever of unknown origin. The model was derived and validated in two separate cohorts of patients from Dicle University Hospital in Diyarbakir, Turkey. A total of 371 patients were enrolled. A diagnostic index score was created using seven independent predictive factors associated with typhoid fever at hospital admission: age <30 years, abdominal distention, confusion, leukopenia, relative bradycardia, positive Widal test and a typhoid tongue. A clinical prediction rule helped to differentiate patients with typhoid fever.

Ciao Salvatore Rubino

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Prof. Salvatore Rubino
Dip. di Scienze Biomediche
V.le San Pietro 43/b
07100 Sassari (Italy)
Tel: +39 79 228302
Fax: +39 79 212345
Cell: +39 33 83865292
Email: mailto:rubino@uniss.it