Treatment of Chronic Biliary Typhoid and Paratyphoid Carriers-Results on 78 Treated Cases Obtained in 16 Years (1963 to 1978)

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  • HIRAISHI Koo
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • SAGARA Hiroko
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • NIWANO Kazutsugu
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • SEO Takehisa
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • MATSUBARA Yoshio
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • AISO Yoshitaka
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • IIMURA Tatsu
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • UKAI Shin-ichiro
    Department of Infectious Diseases, Tokyo Metropolitan Toshima Hospital
  • INOUE Isamu
    Department of Surgery, Tokyo Metropolitan Toshima Hospital
  • KARAKI Kazumori
    Department of Surgery, Tokyo Metropolitan Toshima Hospital
  • KAWAGOE Tokiwa
    Department of Surgery, Tokyo Metropolitan Toshima Hospital
  • MORI Masaho
    Department of Surgery, Tokyo Metropolitan Toshima Hospital
  • TOYODA Tetsuo
    Department of Surgery, Tokyo Metropolitan Toshima Hospital

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Other Title
  • 腸チフス・パラチフス胆道系長期保菌者の治療-16年間 (1963～1978年) 78例の総括
  • チョウチフス パラチフス タンドウケイ チョウキ ホキンシャ ノ チリョウ 1

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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.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 56 (3), 207-217, 1982

    The Japanese Association for Infectious Diseases

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