Kansenshogaku Zasshi
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
Treatment of Chronic Biliary Typhoid and Paratyphoid Carriers-Results on 78 Treated Cases Obtained in 16 Years (1963 to 1978)
Koo HIRAISHIHiroko SAGARAKazutsugu NIWANOTakehisa SEOYoshio MATSUBARAYoshitaka AISOTatsu IIMURAShin-ichiro UKAIIsamu INOUEKazumori KARAKITokiwa KAWAGOEMasaho MORITetsuo TOYODA
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1982 Volume 56 Issue 3 Pages 207-217

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Abstract

From the typhoid and paratyphoid carriers admitted to Tokyo Metropolitan Toshima Hospital during the 16 year period from 1963 to 1978, transient fecal excretors were strictly excluded, 78 chronic biliary carriers were underwent the treatment. The results of the treatment of the 78 cases are reported. In all of these cases, the cholangiographic examination revealed pathological findings such as shadow of biliary calculus, poor visualization and dilatation of common bile duct. As a rule, the treatment was conducted by performing cholecystectomy as far as feasible. In cases where the operation was impossible from various reasons and where postoperative cultural studies were still positive, long term oral treatment with ampicillin was carried out as a rule. In most of the operated cases, excepting that ampicillin was administered for 3 to 4 days before the operation to prevent contamination of the operative field, no chemotherapeutic agent was used combinedly. After treatment, bacterial examinations were made for both stool and bile. Initially, the patients were followed up for 1 year for operated cases and for 2 years for cases treated by chemotherapeutic agent. However, subsequently the follow up period was shortened to 4 months and 1 year, respectively. Seventy cases were treated surgically, of which two cases had been operated in other hospitals. Out of these cases, 52 (74.3%) were proved to be cured by postoperative surveillance. In the remaining 18 cases chemotherapy was performed, with erradication of salmonella in 13 cases. Among 8 cases received chemotherapy only, 6 cases became negative for salmonella after the treatment. Summarizing these results, erradication of salmonella could be obtained in 71 out of 78 cases, with a cure rate of 91%. Taking into account the strictness of the criteria for assessment of clinical efficacy employed by us, these results can be compared considerably favourably with those reported in various papers. In 50 cases the stones removed by cholecystectomy were examined for the presence of salmonella and discussion was made for post-treatment sureillance based on the results obtained and review of literature.

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© The Japansese Association for Infectious Diseases
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