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  1. Fulltext Computed tomography of focal splenic lesions in patients presenting with fever
    Joazlina ZY, Wastie ML, Ariffin N
    Singapore Med J, 2006 Jan;47(1):37-41.
    PMID: 16397719
    INTRODUCTION: There is an awareness of the increased incidence of splenic abscess in Southeast Asia giving rise to unexplained fever. This study looks at the role of computed tomography (CT) in evaluating focal splenic lesions in patients presenting with fever.
    METHODS: 37 patients presenting with fever of unknown origin underwent CT and this study retrospectively analyses the findings in these patients. 13 patients also had associated abdominal pain. Patients with conditions at high risk for splenic infection include: diabetes mellitus in ten patients, leukaemia in seven patients, human immunodeficiency virus infection in five patients, intravenous drug abuse in six patients, and steroid therapy in two patients. No risk factors could be identified in seven patients.
    RESULTS: Splenic abscess was diagnosed in 28 patients. A range of infecting organisms was isolated but the most frequent were Staphylococcus aureus (eight), tuberculosis (four), Streptococcus (four), fungal (four) and melioidosis (four). No infecting organism could be identified in ten cases though in patients with leukaemia with multiple low attenuation areas, the cause was presumed to be fungal. Six patients were diagnosed to have splenic infarcts though differentiation from splenic abscess could be difficult; these patients were treated for an abscess and all had endocarditis. Three patients were subsequently diagnosed with lymphoma. Percutaneous abscess drainage was performed in five patients and splenectomy was carried out in six patients.
    CONCLUSION: CT proved to be very useful as it not only revealed the size and extent of any splenic abnormality but it assisted with guidance for percutaneous drainage, determined the site for biopsy, and provided follow-up after treatment.
    Matched MeSH terms: Fever of Unknown Origin/etiology
  2. Fulltext The burden of typhoid fever in Klang Valley, Malaysia, 2011-2015
    Muhammad EN, Abdul Mutalip MH, Hasim MH, Paiwai F, Pan S, Mahmud MAF, et al.
    BMC Infect Dis, 2020 Nov 16;20(1):843.
    PMID: 33198646 DOI: 10.1186/s12879-020-05500-x
    BACKGROUND: Typhoid fever causes global morbidity and mortality and is a significant health burden, particularly in low- and middle-income countries. The direct fecal-oral route is the main transmission mode, but indirect environmental transmission could occur, particularly in urban settings. This study aimed to investigate the burden and trend of typhoid fever, reporting the coverage system between government and private practice and pattern of multidrug-resistant (MDR) typhoid cases in the urban Klang Valley area from 2011 to 2015.

    METHODS: The data from a cross-sectional study retrieved from the e-Notifikasi System, a national reporting system for communicable diseases provided by the Disease Control Division, Ministry of Health Malaysia and secondary data of all the typhoid cases were obtained from the public and private hospitals and laboratories in Klang Valley. Descriptive analysis was performed to examine the sociodemographic characteristics, spatial mapping was conducted to examine trends, and the crude incidence rates of confirmed typhoid cases and percentage of reporting coverage were calculated. Significant differences between MDR and non-MDR Salmonella typhi were determined in the patient's sociodemographic characteristics, which were analyzed using χ2 test. P values fever cases were reported in Klang Valley; however, only 265 cases were confirmed by culture tests. The crude incidence rates of confirmed cases were between 0.5 to 0.7 but peaked at 1.42 per 100,000 population in 2015. Most typhoid fever cases were observed among men (55.6%), individuals aged 21 to 30 years (27.6%), Malaysians (86.3%) and individuals of Malay ethnicity (52.1%). The reporting coverage of confirmed cases was 78.9% and non-reporting coverage of unconfirmed typhoid cases was 79.5%. The predictive value positive (PVP) was 89.3, and 7.5% were detected as MDR Salmonella typhi. Statistical significance was found in gender, citizenship and ethnicity regarding MDR Salmonella typhi (p = 0.004, p = 0.008 and p = 0.034, respectively).

    CONCLUSIONS: The local transmission of typhoid is still prevalent in the Klang Valley despite rapid urbanization and development in recent years. These findings are essential for policy makers to plan and implement focused and effective preventative activities to curb typhoid infection in urban areas.

    Matched MeSH terms: Typhoid Fever/drug therapy; Typhoid Fever/microbiology; Typhoid Fever/epidemiology*; Typhoid Fever/transmission
  3. Fulltext Yellow fever vaccination in Malaya by subcutaneous injection and multiple puncture. Neutralizing antibody responses in persons with and without pre-existing antibody to related viruses
    Gordon Smith CE, Turner LH, Armitage P
    Bull World Health Organ, 1962;27:717-27.
    PMID: 13993152
    Because of the risk of introduction of yellow fever to South-East Asia, comparative studies were made of yellow fever vaccination in Malayans who had a high prevalence of antibody to related viruses and in volunteers without related antibody. The proportions of positive neutralizing antibody responses to subcutaneous vaccination with 17D vaccine were not significantly different between volunteers with and without heterologous antibody but the degree of antibody response was greater in those without. The ID(50) of 17D in both groups was about 5 mouse intracerebral LD(50). Multiple puncture vaccination with 17D gave a much lower response rate than subcutaneous vaccination in volunteers with heterologous antibody. In both groups subcutaneous doses of about 50 mouse intracerebral LD(50) gave larger antibody responses than higher doses. The neutralizing indices and analysis of results were calculated by a method based on the survival time of the mice. This method, which has advantages over that of Reed & Muench, is fully described in an annex to this paper.
    Matched MeSH terms: Yellow Fever*; Yellow fever virus*
  4. Fulltext Acute mastoid abscess secondary to partially treated upper respiratory tract infection: a case report
    Halimuddin, S., Asma, A.
    Medicine & Health, 2010;5(1):41-44.
    MyJurnal
    Acute mastoid abscess is common in daily practice. In children, it is usually caused by unsuccessful treatment or partially treated acute otitis media (AOM). Some authors had reported that chronic suppurative otitis media (CSOM) can be the source of infection but it is usually associated with the presence of cholesteatoma. A case of an acute mastoid abscess in a 7 year old girl is presented. She had a history of severe otalgia with left post auricular swelling for 3 days. Clinically she was febrile, the left otoscopy showed diffuse post auricular swelling and sagging of the posterior wall of the external canal. She underwent an emergency cortical mastoidectomy for the left mastoid abscess and had an uneventful recovery. In conclusion, this patient was partially treated with antibiotics which increased the risk for ‘masked mastoiditis’, and she later developed a mastoid abscess. Therefore we advocate that all AOM patients should be treated with antibiotics at least for a duration of one week.
    Matched MeSH terms: Fever
  5. Evaluation of the anti-pyretic potential of Orthosiphon stamineus Benth standardized extract
    Yam MF, Ang LF, Basir R, Salman IM, Ameer OZ, Asmawi MZ
    Inflammopharmacology, 2009 Feb;17(1):50-4.
    PMID: 19127348 DOI: 10.1007/s10787-008-8038-3
    The anti-pyretic activity of a standardized methanol/water (50/50) extract of Orthosiphon stamineus Benth. (SEOS) was investigated for its effect on normal body temperature and yeast-induced pyrexia in Sprague Dawley (SD) rats. The SEOS showed no effect on normal body temperature. Doses of 500 and 1000 mg/kg body weight of SEOS significantly reduced the yeast-induced elevation in body temperature. This effect persisted up to 4 h following the administration of the extract. The anti-pyretic effect of SEOS was comparable with that of paracetamol (acetaminophen in U.S) (150 mg/kg p.o.), a standard anti-pyretic agent. HPLC study revealed that rosmarinic acid, sinensetin, eupatorin and tetramethoxyflavone were present in SEOS in the amounts of 7.58%, 0.2%, 0.34% and 0.24% respectively. The LD(50) of the extract in rats was higher than 5000 mg/kg body weight. Therefore, the present study ascertained that SEOS possesses a significant anti-pyretic activity.
    Matched MeSH terms: Fever/drug therapy*
  6. Fulltext Antibiotic prescribing for childhood febrile illness by primary care doctors in Malaysia
    Teng CL, Hanafi NS, Ng CJ, Chia YC, Atiya AS
    J Paediatr Child Health, 2006 Oct;42(10):612-7.
    PMID: 16972968 DOI: 10.1111/j.1440-1754.2006.00937.x
    AIM: Fever in children, a mostly benign and self-limiting illness, is often viewed with consternation by the care givers. It results in early consultation and excessive use of antipyretics and antibiotics. In this study, we document the prescribing practice of doctors from three primary care settings in Malaysia and identify the predictors of antibiotic prescription.
    METHODS: Interview of care givers bringing febrile children (age = 12 years) to three primary care settings: public primary care clinics, private general practice clinics and a university-based primary care clinic.
    RESULTS: Data from 649 children were analysed. Mean age of children 4.1 years and 55% were boys. One-third of the children had prior consultation for the same episode of fever. About 80% of the febrile children were diagnosed to have upper respiratory tract infection, viral fever and gastroenteritis. Overall antibiotic prescribing rate was 36.6% (public primary care clinic 26.8%, private general practice clinic 70.0% and university-based primary care clinic 32.2%). Independent predictors of antibiotic prescription were: clinic setting, longer duration of fever (>7 days), higher temperature (>38 degrees C) and the diagnosis of upper respiratory tract infections. After controlling for demographic and clinical factors, antibiotic prescription in private general practice clinic was seven times higher than public primary care clinic (odds ratio 7.1, 95% confidence interval 4.0-12.7), and 1.6 times higher than university-based primary care clinic (odds ratio 1.6, 95% confidence interval 1.0-2.5).
    CONCLUSION: Differences in the patients' demographic and clinical characteristics could not adequately explain the high antibiotic prescribing rate in private general practice clinics. This inappropriately high antibiotic prescribing for febrile children in private general practice clinics is a suitable target for future intervention.
    Matched MeSH terms: Fever/drug therapy*
  7. The protective effects of Zingiber zerumbet rhizome against fevers in rats
    Mohd Salleh H, Ablat A, Chong SL, Hazni H, Tohar N, Fauzi N, et al.
    Naturwissenschaften, 2024 Apr 01;111(2):20.
    PMID: 38558027 DOI: 10.1007/s00114-024-01907-7
    The Zingiber zerumbet rhizomes are traditionally used to treat fever, and the in vitro inhibitory effect of ethyl acetate extract from Zingiber zerumbet rhizomes (EAEZZR) against DENV2 NS2B/NS3 (two non-structural proteins, NS2 and NS3 of dengue virus type 2) has been reported earlier. This study was carried out to establish an acute toxicity profile and evaluate the anti-fever (anti-pyretic) activities of EAEZZR in yeast-induced fever in rats. The major compound of EAEZZR, zerumbone, was isolated using chromatographic methods including column chromatography (CC) and preparative thin-layer chromatography (PTLC). Additionally, the structure of zerumbone was elucidated using nuclear magnetic resonance (NMR), liquid chromatography mass spectrometer-ion trap-time of flight (LCMS-IT-TOF), infrared (IR), and ultraviolet (UV) spectroscopy. The toxicity of EAEZZR was evaluated using Organization for Economic Cooperation and Development Test Guideline 425 (OECD tg-425) with minor modifications at concentrations EAEZZR of 2000 mg/kg, 3000 mg/kg, and 5000 mg/kg. Anti-fever effect was determined by yeast-induced fever (pyrexia) in rats. The acute toxicity study showed that EAEZZR is safe at the highest 5000 mg/kg body weight dose in Sprague Dawley rats. Rats treated with EAEZZR at doses of 125, 250, and 500 mg/kg exhibited a significant reduction in rectal temperature (TR) in the first 1 h. EAEZZR at the lower dose of 125 mg/kg showed substantial potency against yeast-induced fever for up to 2 h compared to 0 h in controls. A significant reduction of TR was observed in rats treated with standard drug aspirin in the third through fourth hours. Based on the present findings, ethyl acetate extract of Zingiber zerumbet rhizomes could be considered safe up to the dose of 5000 mg/kg, and the identification of active ingredients of Zingiber zerumbet rhizomes may allow their use in the treatment of fever with dengue virus infection.
    Matched MeSH terms: Fever/drug therapy
  8. Fulltext Genome Sequence of Salmonella enterica subsp. enterica Serovar Typhi Isolate PM016/13 from Untreated Well Water Associated with a Typhoid Outbreak in Pasir Mas, Kelantan, Malaysia
    Muhamad Harish S, Sim KS, Najimudin N, Aziah I
    Genome Announc, 2015;3(6).
    PMID: 26564032 DOI: 10.1128/genomeA.01261-15
    Salmonella enterica subsp. enterica serovar Typhi is a human-restricted pathogen that causes typhoid fever. Even though it is a human-restricted pathogen, the bacterium is also isolated from environments such as groundwater and pond water. Here, we describe the genome sequence of the Salmonella enterica subsp. enterica serovar Typhi PM016/13 which was isolated from well water during a typhoid outbreak in Kelantan, Malaysia, in 2013.
    Matched MeSH terms: Typhoid Fever
  9. Fulltext Complete Genome Sequence of Salmonella enterica subsp. enterica Serovar Typhi Isolate B/SF/13/03/195 Associated with a Typhoid Carrier in Pasir Mas, Kelantan, Malaysia
    Muhamad Harish S, Sim KS, Mohd Nor F, Mat Hussin H, Hamzah WM, Najimudin N, et al.
    Genome Announc, 2015;3(6).
    PMID: 26564035 DOI: 10.1128/genomeA.01285-15
    We report here the complete genome sequence of Salmonella enterica subsp. enterica serovar Typhi B/SF/13/03/195 obtained from a typhoid carrier, who is a food handler in Pasir Mas, Kelantan.
    Matched MeSH terms: Typhoid Fever
  10. Fulltext Drug reaction with herbal supplement: a possible case of drug induced lupus erythematosus
    Muthupalaniappen L, Jamani N, Muhammad M, Adawiyah J, Aziz N
    Malays Fam Physician, 2010;5(2):99-100.
    PMID: 25606196 MyJurnal
    A 24-year-old lady presented with four days history of fever, non-pruritic rash, ankle pain and swelling. She had consumed herbal supplement five days before the onset of symptoms. Examinations revealed erythematous maculo-papular lesions of varying sizes on sun exposed areas. Patient was suspected to have Drug Induced Lupus Erythematosus (DILE) and subsequently symptoms subsided rapidly on withholding the herbal medication.
    Matched MeSH terms: Fever
  11. Fulltext Paravertebral Abscess Caused By Bukholderia Pseudomallei In
    Ahmad, S., Azura, L., Duski, S., Aziz, M.Y.
    Malays Orthop J, 2009;3(1):88-90.
    MyJurnal
    A 53-year-old Malay man was admitted with intestinal obstruction, fever and lower limb weakness. Initial clinical impression was myelitis causing paralytic ilues and paraperesis. Blood culture showed Burkholderia pseudomallei infection and subsequent MRI showed paravertebral abscess. This case highlights a rare manifestation of melioidosis involving the spine and difficulties in establishing the diagnosis.

    Matched MeSH terms: Fever
  12. A comparison between infrared tympanic thermometry, oral and axilla with rectal thermometry in neutropenic adults
    Dzarr AA, Kamal M, Baba AA
    Eur J Oncol Nurs, 2009 Sep;13(4):250-4.
    PMID: 19386547 DOI: 10.1016/j.ejon.2009.03.006
    This study assessed the agreement between infrared tympanic membrane (TM), axillary, corrected axillary (+0.5 degrees C), oral, and corrected oral (+0.3 degrees C) to rectal thermometry as reference standard in neutropenic adults. The sensitivity and specificity of the mentioned thermometries in detecting rectal fever (> or =38 degrees C) were also analysed.
    Matched MeSH terms: Fever/chemically induced; Fever/diagnosis*; Fever/microbiology
  13. Fulltext The worst flood in 100 years : Johore experience
    Marzukhi, M.I., Daud, A.R., Badrul Hisham, A.S.
    Malaysian Journal of Community Health, 2009;15(3):1-14.
    MyJurnal
    Past major flooding events for the state of Johore, Malaysia were recorded in 1926, 1967, 1968 and 1971. However, major meteorological phenomena that hit Johore on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) were claimed to be the worst flood disaster in Johore in a 100 years. All eight districts were affected displacing 157,018 and 155,368 population during the first and the second wave event respectively. The Johore Health Department deployed substantial number of medical and health personnel to deal with the Johore flood crisis. Flood-related data were collected on daily basis between 19th December 2006 and 19th February 2007 using spreadsheet format from Flood Operational Rooms located at respective District Health Offices. Among flood victims 34,530 were found to have non-communicable diseases and 19,670 with communicable diseases. No major food- and water-borne disease outbreaks, such as cholera and typhoid, were reported in Johore. High success of public health measures was depending on the workforce of medical and health personnel on the ground. On the other hand, voluntary services offered by non-governmental organisations (NGOs), private sector and other volunteers should be well coordinated without compromising regulatory and ethical requirements. Crisis guidelines and plan of actions shall be updated so that they would be more relevant to the crises encountered on the ground.
    Matched MeSH terms: Typhoid Fever
  14. Fulltext Melioidosis in acute cholangitis of diabetic patient: a forgotten diagnosis
    Mohamad N, Ponnusamy S, Devi S, Manikam R, Idrus II, Bakar NHA
    Res Rep Trop Med, 2012;3:103-106.
    PMID: 30100777 DOI: 10.2147/RRTM.S34483
    Melioidosis presents with a wide range of clinical presentations, which include severe community-acquired pneumonia, septicemia, central nervous system infection, and less severe soft tissue infection. Hence, its diagnosis depends heavily on the clinical microbiology laboratory for culture. In this case report, we describe an atypical presentation of melioidosis in a 52-year-old man who had fever, right upper-abdominal pain, and jaundice for 15 days. Melioidosis caused by Burkholderia pseudomallei was subsequently diagnosed from blood culture. As a primary care physician, high suspicion index is of great importance. High suspicion index of melioidosis in a high-risk group patient, such as the patient with diabetes mellitus and diabetic foot, is crucial in view of atypical presentations of pseudomonas sepsis. A correct combination of antibiotic administration in the early phase of therapy will determine its successful outcome.
    Matched MeSH terms: Fever
  15. Toll-like receptor 4 Asp299Gly and Thr399Ile polymorphisms and typhoid susceptibility in Asian Malay population in Malaysia
    Bhuvanendran S, Hussin HM, Meran LP, Anthony AA, Zhang L, Burch LH, et al.
    Microbes Infect, 2011 Sep;13(10):844-51.
    PMID: 21612766 DOI: 10.1016/j.micinf.2011.04.007
    Typhoid fever is a major health problem with frequent outbreaks in Kelantan, Malaysia. Prevalence of TLR4 gene polymorphisms varies with ethnic groups (0-20%) and predisposean individual to gram-negative infections. The prevalence rate of TLR4 Asp299Gly and Thr399lle polymorphisms in the Malay population or the influence of these on typhoid fever susceptibility is not yet reported. 250 normal and 304 susceptible Malay individuals were investigated for these polymorphisms using allele-specific PCR and analysed for its association with typhoid fever susceptibility. The total prevalence of polymorphisms in the normal population was 4.8% in comparison to 12.5% in the susceptible population (p = 0.002). An increased frequency of both polymorphisms was observed in the susceptible population (p fever in Kelantan could be attributed to the higher percentage of Malays (95%) in this state. In order to reduce the incidence of this disease, people with these polymorphisms, can be prioritised for prophylactic strategies.
    Matched MeSH terms: Typhoid Fever/genetics*; Typhoid Fever/immunology
  16. Use of Indomethacin as an anti-pyretic agent in malignant reticulosis
    Banerjee AK
    Med J Malaya, 1972 Mar;26(3):173-8.
    PMID: 4555503
    Matched MeSH terms: Fever/drug therapy*; Fever/etiology
  17. Fulltext Temperature-regulated expression of outer membrane proteins in Shigella flexneri
    Harikrishnan H, Ismail A, Banga Singh KK
    Gut Pathog, 2013;5(1):38.
    PMID: 24330657 DOI: 10.1186/1757-4749-5-38
    Bacteria exist widely in a diversity of natural environments. In order to survive adverse conditions such as nutrient depletion, biochemical and biological disturbances, and high temperature, bacteria have developed a wide variety of coping mechanisms. Temperature is one of the most important factors that can enhance the expression of microbial proteins. This study was conducted to investigate how outer membrane proteins (OMPs) of the bacterium Shigella flexneri respond to stress, especially during fever when the host's body temperature is elevated.
    Matched MeSH terms: Fever
  18. Immature platelet fraction as a useful marker in Crimean-Congo hemorrhagic fever
    Ozmen ZC, Deveci K, Coskun USS, Ozmen Z, Aydogan L, Barut HS
    Trop Biomed, 2023 Mar 01;40(1):101-107.
    PMID: 37356009 DOI: 10.47665/tb.40.1.016
    The aim of this study is to evaluate the clinical significance and diagnostic performance of the immature platelet fraction (%IPF) in Crimean-Congo hemorrhagic fever (CCHF). Samples obtained from 32 healthy control subjects and 40 CCHF patients (9 positive and 31 negative radiological findings) were evaluated in the study. The samples obtained from CT-positive subjects demonstrated higher IPF% values which also exhibited a positive correlation with mean platelet volume (MPV) and platelet size deviation width (PDW) values.The patient group IPF% values were positively correlated with the duration of hospital stay. The ROC analysis also suggested the potential importance of IPF values higher than 10.5% in diagnosing CCHF patients with positive radiological findings.The results of our study showed that % IPF can be considered as a useful parameter in the follow-up of the disease course in patients with CCHF.
    Matched MeSH terms: Hemorrhagic Fever Virus, Crimean-Congo*
  19. "Preliminary report of the beneficial effect of chloromycetin in the treatment of typhoid fever"--a commentary
    Basnyat B
    Wilderness Environ Med, 2004;15(3):216-7.
    PMID: 16331874
    Matched MeSH terms: Typhoid Fever/drug therapy; Typhoid Fever/history*
  20. Listeriosis in pregnancy: a challenge in diagnosis
    Basri NI
    BMJ Case Rep, 2024 Apr 08;17(4).
    PMID: 38589245 DOI: 10.1136/bcr-2024-259938
    Listeriosis is a rare foodborne infection caused by Listeria monocytogenes It has been reported to be commonly found among the obstetric population, immunocompromised group and elderly, presumably due to the lower immunity status in these populations. Presentation in pregnancy is usually non-specific like fever, diarrhoea, respiratory tract symptoms and preterm rupture of membrane. These make the diagnosis challenging and may delay the correct management. We present a case of a female in her early 40s, gravida 4 para 0+3 at 27 weeks who presented with fever. She later developed preterm rupture of membrane 24 hours after admission. The leaking of liquor later changed from clear to meconium stained raising the suspicion of listeria chorioamnionitis, necessitating an emergency preterm delivery via caesarean section. The newborn acquired listeria infection and required ventilation support. He subsequently was discharged from neonatal unit after nearly 3 months of life.
    Matched MeSH terms: Fever/complications
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