Aggressive fluid resuscitation and broad spectrum antibiotics decrease mortality from typhoid ileal perforation.

Abstract:

:One of the most severe complications of typhoid enteritis is perforation of ileal ulcerations. The typically high mortality rates from these perforations are in part due to extremely limited supportive care in hospitals in typhoid endemic areas. In the setting of a rural African hospital, this study demonstrated a decrease in overall mortality rate from 40% with one layer closure and chloramphenicol alone to 19% with two-layer closure and chloramphenicol, gentamicin and metronidazole. This was primarily due to a decrease in late (> 24 h) mortality. There was also a decrease in overall mortality rate from 43% with < 10 ml/kg of intraoperative fluid administration to 14% with > 10 ml/kg. This was primarily due to a decrease in early (< 24 h) mortality. Even within the constraints of the rural developing world, more aggressive initial fluid resuscitation can decrease early mortality, while broader spectrum antibiotics and two-layer closure can decrease late mortality from typhoid ileal perforation.

journal_name

Trop Doct

journal_title

Tropical doctor

authors

Mock C,Visser L,Denno D,Maier R

doi

10.1177/004947559502500309

subject

Has Abstract

pub_date

1995-07-01 00:00:00

pages

115-7

issue

3

eissn

0049-4755

issn

1758-1133

journal_volume

25

pub_type

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