Frequency of leukocytosis in culture proven enteric fever in children.

Objective: To determine the frequency of leukocytosis in patients of culture proven enteric fever in children over one year period. Study Design: Retrospective Cross-sectional study. Setting: Department of Paediatrics, at Fatima Memorial Hospital, Shadman Lahore. Period: January 2020 to December 2020. Material & Methods: The case record of patients diagnosed with enteric fever on blood culture were reviewed. All patients in the age group of one year to 15 years with a discharge diagnosis of enteric fever for admitted inpatient or from Outpatient Department (OPD) were included in the study. Results: Median age was 61.3 (IQR 38) months and slight female preponderance 61 out of 110 patients (55.5%) was observed. Median duration of fever before presentation was eight days with IQR of 7.3 days and 95 patients has shown anorexia (86.4%), which was the most common symptom after fever. S. Typhi was found in 76.4% (84 patients out of 110) of positive blood cultures and 23.6% of positive culture (26 cases) found S. Paratyphi A,B,C. Only 8 cases (5 %) of enteric fever were multisensitive with 93% of isolates (102 cases) were either multidrug resistant (45 cases (41%) or 57 cases Extended drug resistant (52%).18 out of 110 patients (16%) has shown leukocytosis and leukocyte count was normal in 73% patients (80 out of 110). Among leukocytosis group strikingly, 89% of patients (16 out of 18) had shown extended drug resistant pattern (XDR). Conclusion: Leukocytosis in Typhoid fever is not uncommon and culture proven Typhoid Fever can be associated with leukocytosis in children. Once there is leukocytosis in culture proven Typhoid fever, there is a high incidence of XDR typhoid.