Objective: Present the epidemiology and clinical characteristics of typhoid fever in the Lebanon.
Methods: Retrospective study of 52 patients admitted to a university hospital center between 1995 and 1999. The criteria for inclusion were a positive Salmonella typhi or paratyphi hemoculture and/or Widal serodiagnosis > 1/160 for O agglutinin, in the presence of evocative symptoms.
Results: The patients were aged a mean of 31 +/- 24 years. The mean duration between the onset of fever and diagnosis was of 10 +/- 8 days. Fever was observed in 96% of cases and the other predominant symptoms were diarrhea (37%), abdominal pain (31%) and headache (29%). Feverish gastroenteritis is a frequent manifestation in children (61% of cases). Complications were noted in 33% of cases and were predominantly digestive. Leukopenia is not a good diagnostic marker. S. typhi was the cause in 83% of cases. Resistance to ampicillin was noted in 13% of cases, to cotrimoxazole and to chloramphenicol in 10% and to ofloxacine in 3% of cases. One death was reported (2%) of an immunodepressed patient.
Conclusion: Typhoid fever is still an endemic disease in the Lebanon and should be systematically evoked in the case of prolonged fever, feverish gastroenteritis and/or headache. The appearance of bacteria resistant to antibiotics makes ceftriaxone or ciprofloxacine the empirical treatment of choice.