The study group consisted of 56 patients in acute stage of typhoid fever, 35 men and 21 women, who admitted to Tokyo Metropolitan Toshima Hospital between January 1.1970 and December 31. 1979. All of the patients without hypertension or any other cardiac disease, revealed
S. typhi in blood or stool culture and were examined body temperature, blood pressure, electrocardiogram, chest X-ray film, complete blood count, serum electrolytes, GOT, GPT, LDH and Al-P on admission.
Twenty-five (44.6%) of 56 patients demonstrated some abnormal electrocardiographic findings (abnormal ST-T change: 9 patients, QTc prolongation over 0.45 sec.: 9 patients, first degree A-V block: 5 patients, premature ventricular contraction: one patient and complete right bundle branch block: one patient) and the remaining 31 cases (55.4%) showed normal findings.
The longer bacteremia
S. typhi remained, the more abnormal electrocardiographic findings found. Because the incidence of abnormal findings was indicated 20.0% during one to 10 days after onset of typhoid fever, 40.0% during eleven to 20 days and 77.8% during twenty-one to 30 days.
Ten (18.9%) of 53 patients whose chest X-ray film we were able to study showed CT ratio more than 50% and eight of them were disclosed abnormal electrocardiographic findings. These results indicate that cardiac enlargement may be associated with abnormal electrocardiographic findings.
Relative bradycardia, one of the trias of typhoid fever, was confirmed in this study group. However, in the patients having severe anemia less than 10 g/dl of hemoglobin we could not find out the relative bradycardia. And the relative bradycardia was not thought as the clinical manifestation of myocarditis caused by
S. typhi because it was little related to QTc prolongation, A-V block, cardiac enlargement and elevation of GOT, GPT and LDH.
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