have been involved in the course of enteric fever, resulting The liver is commonly involved in patients with tyin a wide array of presentations. 2 Abnormalities of liver biophoid fever. However, severe hepatic derangement simchemical tests are commonly found in patients with typhoid ulating acute viral hepatitis is rare. Our aim was to charfever. 3 However, a picture of hepatitis with fever and frank acterize the clinical picture, biochemical features, and jaundice characterizes the course of a small subset of these prognosis of Salmonella hepatitis. Retrospective casepatients. 4 The picture of Salmonella hepatitis may be indiscontrol analysis of medical records included 27 patients tinguishable from acute viral hepatitis. Lack of appropriate with Salmonella hepatitis and 27 inpatients with acute testing for Salmonella infection may result in a considerable viral hepatitis from 1973 to 1993. Travel history, clinical delay in making the diagnosis and initiating proper therapy. picture, a standard battery of 18 biochemical tests, comThis delay could adversely affect the outcome of these paplete blood counts, disease complications, duration of tients and increase the cost of their medical care. hospital admission, and final outcome were analyzed.Over the past 20 years, we have encountered 27 well-docuEleven patients with Salmonella hepatitis (40%) travmented cases of typhoid fever presenting with a picture of elled abroad within 1 month of illness. A greater proporacute hepatitis. Several of these patients had a stormy course tion of Salmonella hepatitis patients developed fever and required prolonged intensive medical care or surgical ú104Њ (44% vs. 4%, respectively; P õ .0001), and had relaintervention to correct the complications of their infection. tive bradycardia (42% vs. 4%, respectively; P õ .002) thanWe will outline the clinical picture, biochemical profile, yield viral hepatitis patients. Salmonella hepatitis was associof various diagnostic studies, and prognosis of these patients. ated with lower peak serum alanine transaminase A group of patients with acute viral hepatitis, requiring ad-(ALT), aspartate transaminase, and higher peak serum mission to the hospital for the severity of their illness, will be alkaline phosphatase (296 vs. 3,234 U/L, 535 vs. 2,844 U/ used to highlight the differences that could help the clinician L, and 500 vs. 228 U/dL, respectively; P õ .0001, õ.0003, suspect the presence of an unusual cause of acute hepatitis.
