Changing spectrum of typhoid.

To determine the changing spectrum of typhoid fever, a study was conducted on 240 cases of typhoid fever, admitted over a period of 4 years. The classical 'Stepladder fever' and 'relative bradycardia' were less commonly seen. Presentation as hepatitis, psychosis, meningism, myocarditis, polyneuropathy and diarrhea were encountered in a small number of patients. Reversible proximal myopathy occurred in four patients and all of them recovered completely over a period of 2-3 weeks. The total leukocyte counts were within normal range in most of the cases. Bone marrow cultures were positive in all untreated and partially treated patients. All strains of Salmonella typhi in this study were sensitive to ofloxacin ceftriaxone and ciprofloxacin.