Table 1 Age distribution 1966, , 5 ( ): Carrier Table 2 Symptoms of 38 patients with the typhoid fever Fig. 1 Annual Incidence of Typhoid Fever

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1 Key words: typhoid fever, MIC, liver function, LDH isozyme

2 Table 1 Age distribution 1966, , 5 ( ): Carrier Table 2 Symptoms of 38 patients with the typhoid fever Fig. 1 Annual Incidence of Typhoid Fever in Nagasaki

3 Table 3 Clinical and laboratory examinations Fig. 2 Laboratory findings of patients with typhoid fever before (B) and after (A) treatment Table 4 Titers of agglutinins to the 0, H and Vi antigens of the bacillus Table 5 Isolations of S. typhi from various materials

4 Fig. 4 Laboratory findings of patients with typhoid fever before (B) and after (A) treatment Fig. 3 Laboratory findings of patients with typhoid fever before (B) and after (A) treatments

5 Table 6 LDH isozymes, ICG and BSP on admission Table 7 Phage typing of 27 strains of S. typhi from various clinical specimens

6 Table 8 Minimum inhibitory concentrations of various antibiotics to 27 strains of S. typhi isolated from patients with typhoid fever Inoculum size: 106cells/ml Fig. 6 Susceptibility of 27 Strains of S. typhi to various Antibiotics Inoculum size: 106 cells/ml

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9 3) Ames, W. R. & Robins, M.: Age and sex as 13) Gilman, R.H., et al.: Relative efficacy of factors in development of typhoid carrier blood, urine, rectal swab, bone-marrow and state, and method for estimating carrier rose-spot cultures for recovery of Salmonella prevalence. Am. J. Public Health, 33: , typhi in typhoid fever. Lancet, 1: , ) Tynes, B. S. & Utz, J. P.: Factors influencing 14) Brown, J. D., Mo, D. H. & Rhoades, E. R.: the cure of salmonella carriers. Ann. Int. Med., Chloramphenicol-resistant Salmonella typhi in 57: , Saigon. J. Am. Med. Assoc., 231: , ) Sitprija, V., Pipatangue, V., Boonpucknavig, V. & Boonpucknavig, S.: Glomerulitis in typhoid fever. Ann. Int. Med., 81: , ) Choudhry, V. P., Singh, B. M. & Sinclair, S.: 16) Jonsson, M. & Tunevall, G.: FL 1039: A Salmonella nephritis. Indian Pediatrics, 14: new p-lactam derivative for the treatment of , infections with gram-negative bacteria. Infection, 3: 31-36, ) Lehman, J. S..jr., Higashi, G. I., Bassily, S. & Forid, Z.: Rheumatoid factors in salmonella 17) Bentzen, A. J., Vejlsgaard, R., Jacobsen, J. & and shistosoma infections. Trans. Roy. Soc. Tybring, L.: Clinical evaluation of a novel Trop. Med., 66: , lactam antibiotic: Pivmecillinam (FL 1039) Ĉ. Infection, 3: , ) Gangarosa, F. J., et al.: An epidemic-associated episome? J. Inf. Dis., 126: , ) Butler, T., et al.: Therapy of antimicrobial- typhoid fever. Antimicrob. Agents resistant Chemother., 11: , 1977.

10 Clinical and biochemical findings in typhoid fever Nagasaki Municipal Medical Center Keizo YAMAGUCHI, Akihiro HAMAMOTO, Yoshito TANAKA, Yoji SUZUYAMA & Hisashi ISHIKAWA Second Department of Internal Medicine, Nagasaki University School of Medicine Yoshiteru SHIGENO, Masaki HIROTA, Masao NAKATOMI, Masaru NASU, Atsushi SAITO & Kohei HARA Present paper discussed on the results of both clinical and laboratory findings of patients with typhoid fever, who were admitted to Nagasaki Municipal Medical 1963 to Center during the period from Number of patients was 2 to 12 cases in each year and a total of 95 cases were objected in this study. The cases with the typical symptoms of typhoid fever were very few because of early chemotherapies, and some of them were transfered to our hospital as FUO or under the diagnosis of influnza, blood disease, hepatitis, rheumatic fever and so on. Regarding to laboratory findings on admission, positive CRP and elevations of cc2-globulin, LDH values which reflect inflammation were found in the majority of the patients and a positive rate for RA test was 37.5 percent. LDH isozymes showed increases of fraction 4 and 5 and relative decreases of 1 and 2. Furthermore, slight to moderate elevations of GOT, GPT, y-gtp, alkaline phosphatase and LAP were frequently observed, but almost all of these abnormal findings were rapidly improved on convalescent period after the chemotherapies. Isolation rate of S. typhi from the patients was highest from the bone marrows, followed by blood, biles, feces and urine in order. Susceptibilities of 27 clinical isolates of S. typhi to 16 kinds of antibiotics were tested by the agar dilution method. The result revealed that Cefotaxime was most excellent regarding to antibacterial activity and its MIC value was 0.05 pg/ml with inoculaum size of 106 cells/mi. Pivmecillinam followed it with MIC value of 0.05 to 0.1 pg/ml and these of CP, A BPC and ST which had been often used clinically were 3.13, 0.39 to 0.78 pg/ml, respectively.

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