Salmonella Hepatitis: Analysis of 27 Cases and Comparison With Acute Viral Hepatitis

El-Newihi, Hussein M.; Alamy, M.; Reynolds, Telfer B.

doi:10.1002/hep.510240308

Cited by 74 publications

(31 citation statements)

References 9 publications

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“…The presentation with marked elevation of transaminases similar to that of acute viral hepatitis, as observed in this case, has been reported by others. [8910] Recognition of this clinical condition is particularly important in tropical countries where malaria and viral hepatitis are quite common. El-Newihi et al .…”

Section: Discussionmentioning

confidence: 99%

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Salmonella Hepatitis: An Uncommon Complication of a Common Disease

Karoli

Fatima

Chandra

et al. 2012

J Family Med Prim Care

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Typhoid fever is a very common infectious disease of tropics, associated with high morbidity and mortality. Typhoid fever is often associated with hepatomegaly and mildly deranged liver functions; a clinical picture of acute hepatitis is a rare complication. We report a young patient who presented with fever and jaundice and was found to have acute hepatitis secondary to typhoid fever. Recognition of Salmonella hepatitis is of clinical importance as it can mimic acute viral hepatitis. Early institution of specific therapy can improve the prognosis in these patients. Typhoid fever is a very common infectious disease of tropics, associated with high morbidity and mortality. Typhoid fever is often associated with hepatomegaly and mildly deranged liver functions; a clinical picture of acute hepatitis is a rare complication. We report a young patient who presented with fever and jaundice and was found to have acute hepatitis secondary to typhoid fever. Recognition of Salmonella hepatitis is of clinical importance as it can mimic acute viral hepatitis. Early institution of specific therapy can improve the prognosis in these patients.

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Section: Discussionmentioning

confidence: 99%

“…El-Newihi et al . [9] did a retrospective analysis to compare clinical, biochemical picture, and the outcome of patients with Salmonella hepatitis and acute viral hepatitis. They concluded that the clinical picture of Salmonella hepatitis is frequently indistinguishable from that of viral hepatitis.…”

Section: Discussionmentioning

confidence: 99%

Salmonella Hepatitis: An Uncommon Complication of a Common Disease

Karoli

Fatima

Chandra

et al. 2012

J Family Med Prim Care

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“…The principal clinical syndromes associated with Salmonella infection range from selflimited gastrointestinal infections to systemic infections (7). Recently, acute liver injury has been reported in humans infected with Salmonella enterica serovar Typhi through the oral route, and this condition has been termed Salmonella hepatitis; patients usually present with hepatomegaly and a moderate elevation in transaminase levels (8,9).…”

mentioning

confidence: 99%

Toll-Like Receptor 2 (TLR2) and TLR9 Play Opposing Roles in Host Innate Immunity against Salmonella enterica Serovar Typhimurium Infection

et al. 2015

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bToll-like receptors (TLRs) are evolutionarily conserved host proteins that are essential for effective host defense against pathogens. However, recent studies suggest that some TLRs can negatively regulate immune responses. We observed here that TLR2 and TLR9 played opposite roles in regulating innate immunity against oral infection of Salmonella enterica serovar Typhimurium in mice. While TLR9 ؊/؊ mice exhibited shortened survival, an increased cytokine storm, and more severe Salmonella hepatitis than wild-type (WT) mice, TLR2 ؊/؊ mice exhibited the opposite phenomenon. Further studies demonstrated that TLR2 deficiency and TLR9 deficiency in macrophages both disrupted NK cell cytotoxicity against S. Typhimurium-infected macrophages by downregulating NK cell degranulation and gamma interferon (IFN-␥) production through decreased macrophage expression of the RAE-1 NKG2D ligand. But more importantly, we found that S. Typhimurium-infected TLR2 ؊/؊ macrophages upregulated inducible nitric oxide synthase (iNOS) expression, resulting in a lower bacterial load than that in WT macrophages in vitro and livers in vivo as well as low proinflammatory cytokine levels. In contrast, TLR9 ؊/؊ macrophages showed decreased reactive oxygen species (ROS) expression concomitant with a high bacterial load in the macrophages and in livers of TLR9؊/؊ macrophages were also more susceptible than WT macrophages to S. Typhimurium-induced necroptosis in vitro, likely contributing to bacterial spread and transmission in vivo. Collectively, these findings indicate that TLR2 negatively regulates anti-S. Typhimurium immunity, whereas TLR9 is vital to host defense and survival against S. Typhimurium invasion. TLR2 antagonists or TLR9 agonists may thus serve as potential anti-S. Typhimurium therapeutic agents. During the early stages of infection, the innate immune system serves as the first line of defense against microbial replication and spread before an adaptive response is mounted (1). As one mechanism to elicit a rapid and appropriate innate immune response against pathogen infection, pattern recognition receptors (PRRs) evolved in the host to recognize various microbial molecular patterns. In response, pathogens evolved to use many different tactics, including subversion of some of these host antimicrobial immune mechanisms, in order to ensure their multiplication, survival, and persistence in the host (2). This ongoing interplay between host innate immune responses and pathogen virulence factors largely determines the outcome of most infections.As the most widely studied PRRs, Toll-like receptors (TLRs) play a crucial role in pathogen recognition and the induction of immune responses. Currently, 11 and 13 TLRs have been identified in humans and mice, respectively. They are widely expressed on many cell types, such as macrophages, neutrophils, dendritic cells (DCs), and mucosal epithelial cells. TLR signaling results in the induction of reactive oxygen species (ROS) and the activation of the transcription factor NF-B, which in turn induce...

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“…Therefore, these 2 diseases may occur simultaneously. It has been reported that the ratio of ALT to LDH may distinguish hepatitis caused by Salmonella (<4.0) and acute viral hepatitis (>5.0) [15], and the ration here was 4.13. When the patient was examined upon admission to our hospital, it is likely that his aminotransferase levels had already decreased because hepatitis A is usually a self-limiting illness.…”

Section: Discussionmentioning

confidence: 56%

Recurrent paratyphoid fever A co-infected with hepatitis A reactivated chronic hepatitis B

Liu

Xiong

Huang

et al. 2014

Ann Clin Microbiol Antimicrob

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We report here a case of recurrent paratyphoid fever A with hepatitis A co-infection in a patient with chronic hepatitis B. A 26-year-old male patient, who was a hepatitis B virus carrier, was co-infected with Salmonella enterica serovar Paratyphi A and hepatitis A virus. The recurrence of the paratyphoid fever may be ascribed to the coexistence of hepatitis B, a course of ceftriaxone plus levofloxacin that was too short and the insensitivity of paratyphoid fever A to levofloxacin. We find that an adequate course and dose of ceftriaxone is a better strategy for treating paratyphoid fever. Furthermore, the co-infection of paratyphoid fever with hepatitis A may stimulate cellular immunity and break immunotolerance. Thus, the administration of the anti-viral agent entecavir may greatly improve the prognosis of this patient with chronic hepatitis B, and the episodes of paratyphoid fever and hepatitis A infection prompt the use of timely antiviral therapy.

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Salmonella Hepatitis: Analysis of 27 Cases and Comparison With Acute Viral Hepatitis

Cited by 74 publications

References 9 publications

Salmonella Hepatitis: An Uncommon Complication of a Common Disease

Salmonella Hepatitis: An Uncommon Complication of a Common Disease

Toll-Like Receptor 2 (TLR2) and TLR9 Play Opposing Roles in Host Innate Immunity against Salmonella enterica Serovar Typhimurium Infection

Recurrent paratyphoid fever A co-infected with hepatitis A reactivated chronic hepatitis B

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