To investigate the epidemiological and clinical features of a occurrence of typhoid fever, and to furtherly guide the clinical diagnosis and treatment to reduce the misdiagnosis of missed diagnosis.

A clustering event of typhoid fever from Beijing Ditan Hospital, Capital Medical University in August 2018 was reviewed, retrospectively. The epidemiology, clinical symptoms and laboratory examination were analyzed, respectively.

All the 13 patients were sanitation workers in Pinggu Area of Beijing, including 8 females and 5 males, aged 36-48 years old, with similar epidemiological history. Fever was the primary manifestation, 12 patients (92.3%) of the patients had digestive tract symptoms, and 6 patients (46.2%) had respiratory symptoms. The white blood cell count of 13 patients was (5.22% ± 1.73) × 10⁹/L, 5 patients (38.5%) with white blood cell decreased; the counts of eosinophils of 7 patients (53.9%) were lower than the lower limit. There were 11 patients (84.6%) with abnormal liver function. The average level of C-reactive protein (CRP) was 32.5 (8.15, 49.45) mg/L. The level of procalcitonin (PCT) was elevated in only one patient, and there were no significant abnormalities in PCT of the other 12 patients. Abdominal ultrasound showed abnormality in 9 patients. Chest radiography of 1 patient showed cord shadow in the right lung, and chest radiography of 1 patient showed inflammation in the left lingual lobe. The positive rate of blood culture was 84.6%; the positive rate of Widal’s reaction in convalescent period was 61.5% (8/13); 13 patients were all discharged after treatment.

The 13 patients were aggregation disease, with mild condition, atypical symptoms, and liver function damage were more common. The symptoms of the respiratory tract should be alerted to, in order to avoid misdiagnosis of cases with pneumonia as the primary expression; mild and atypical patients should avoid missed diagnosis. It is necessary to carry out the blood culture as early as possible to help clarify the diagnosis, Widal’s reaction negative cannot rule out typhoid fever.