Hematological parameters of Salmonella typhi and paratyphi culture positive patients from Kathmandu Valley, Nepal

Abstract

Introduction: Salmonella enterica causes febrile illnesses leading to changes in hematological parameters. Developing countries like Nepal remain an endemic area for this disease. However, the changes in hematological parameters among Nepalese population have not been well documented in correlation with culture diagnosed cases.

Methods: A total of 204 individuals (102 cases and 102 controls) were included in a cross-sectional, analytical comparative study. The cases and controls were recruited from the tertiary care centers in Kathmandu. The hematological parameters from both culture diagnosed and controls were measured.

Results: Enteric fever (102 culture positive cases) caused a significant decrease in total white blood cell (p < 0.05), blood platelet count (p < 0.05), lymphocyte (p < 0.05), packed cell volume (p < 0.05), eosinophils (p < 0.05) and haemoglobin (p < 0.05) compared to healthy controls. Similarly, enteric fever led to significant increase in neutrophil and monocyte count in enteric fever patients (p < 0.05).S. typhi was isolated in 60 (59%) and S. paratyphi was isolated in 42 (41%) of the patients. Anemia was found in 24 (23.52 %).Leucopenia was found in 8 (7.84%) patients, leucocytosis in 3(2.94%), neutrophilia in 29 (28.43%), lymphocytopenia in 19 (18.62%), monocytopenia in 48 (47.05%), absolute eosinopenia in 95 (93.13%), thrombocytopenia in 24(23.52%) and thrombocytosis in 2(1.96%).

Conclusion: Enteric fever was associated with leucopenia, mild neutrophilia, lymphopenia, absolute eosinopenia and decrease in haemoglobin among culture positive patients. Salmonella enterica serotype Typhi contributed febrile burden higher 59% (60).