Enteric fever in young Yoruba children

Ninety seven Nigerian children under 5 yr of age had typhoid or paratyphoid fever proved by blood culture. They presented with fever, anaemia, gastrointestinal or neurological disturbances, and typhoid and paratyphoid appeared clinically indistinguishable. In this holoendemic malarial area, malaria was the most important differential diagnosis, and may have contributed to the concomitant anaemia seen in the majority of patients. Despite vigorous therapy with chloramphenicol or trimethoxazole, and blood transfusion where indicated, the mortality in both typhoid and paratyphoid was high (18% in both groups).