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Pediatrics General 0e596d2d

Which of the following is true regarding Typhoid in children :

A
Leukochyosis is characteristic
B
Encephalitis is common
C
Mild splenomegaly is usual
D
Urine culture is positive in 4 to 6 days
High-Yield Explanation
Typhoid in children : Splenomegaly is usual and seen in about 90% of patients. The spleen is palpable for 1 of 2 cm below the costal margin (Mild Splenonzegaly) in over 2/3 rd of patients. Blood counts usually show a normal or low leukocyte count (not leuhocytosis). There is always a moderate neutropenia leading to relative lymphocytosis. Neurological complications are uncommon and seen in about 3% of cases. These include encephalitis, meningitis, peripheral neuritis, aphasisa and cerebral vein thrombosis. Stool & Urine culture may reveal Salmonella after 2 weeks of illness (not on 4th to 6th day). Two important manifestation of typhoid fever in adults which are uncommon in children include : Stepladder pattern of fever characteristic in adults is not seen in children. In children the onset is generally sudden with rapid elevation of temperature associated with headache and vomiting. Relative Bradycardia seen in adults is not always present in children. Pulse rate may rise proprotionately to the height of temperature.

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