Typhoid fever complicated by multiple organ involvement: report of two cases

Huang, Guan-Cheng; Chang, Chia‐Ming; Ko, Wen Chien; Yu-lun, Huang; Chuang, Yin-Ching

doi:10.1016/j.jinf.2004.08.018

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…Blood culture isolated S. typhi . Patient was treated with ceftriaxone and the patient was clinically improved and discharged in the 14th day of hospitalization [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…DIC is mostly a subclinical event, and the severe bleeding complications are not typically found in typhoid fever, although DIC score indicates an imbalance of coagulation and fibrinolysis which are markedly elevated in patients with typhoid [ 11 ]. Nishida et al reported a case of typhoid fever complicated by DIC in a 7-year-old male, with acute DIC score of 4, but no sign of bleeding was found [ 10 ]. Coagulation problems involve three major processes: pro-coagulation, anti-coagulation, and fibrinolysis.…”

Section: Discussionmentioning

confidence: 99%

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Sepsis and disseminated intravascular coagulation are rare complications of typhoid fever: A case report

Nurnaningsih

William

Rusmawatiningtyas

et al. 2022

Annals of Medicine &Amp; Surgery

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Introduction and importance: Typhoid fever is an infection caused by Salmonella typhi . The common complications are intestinal perforation and typhoid encephalopathy. Cases of typhoid fever with sepsis and/or disseminated intravascular coagulation (DIC) are rarely reported, even though typhoid fever is endemic in Indonesia. Case presentation A 4-year-old male referral case from a district hospital was experiencing fever, decrease of consciousness and massive bleeding from his gastrointestinal tract and nose. Investigation revealed results from the IgM typhoid test using Tubex®TF, with the score of +8. PELOD 2 score was 10, and PSOFA was 5. DIC score was 7. Based on these findings, the patient was diagnosed with typhoid fever, with DIC and sepsis being the complication of the typhoid fever. Clinical discussion DIC is mostly a subclinical event, and severe bleeding complications found in typhoid fever are uncommon, although DIC scores which indicate an imbalance of coagulation and fibrinolysis are markedly elevated in patients with typhoid. DIC can be a part of multi-organ dysfunction due to sepsis syndrome. Acute infection can also result in systemic activation of coagulation. Conclusion Sepsis and DIC are rare complications of typhoid fever. Typhoid fever can be presented with profound bleeding manifestation other than gastrointestinal bleeding, since it is a common symptom of typhoid fever. Further research should be conducted to postulate association between typhoid fever and DIC.

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“…Blood culture isolated S. typhi . Patient was treated with ceftriaxone and the patient was clinically improved and discharged in the 14th day of hospitalization [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sepsis and disseminated intravascular coagulation are rare complications of typhoid fever: A case report

Nurnaningsih

William

Rusmawatiningtyas

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Typhoid is still a challenging disease having multiple organ damage (Huang et al 2005). However, liver is the primary organ that is affected in the patients with typhoid fever (Shetty et al 1999).…”

Section: Discussionmentioning

confidence: 99%

Protection against experimental salmonellosis by recombinant 49 kDa OMP of Salmonella enterica serovar Typhi: biochemical aspects

Kaur

Jain

2013

Biologia

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Typhoid fever is systemic illness caused by Salmonella enterica serovar Typhi (S. Typhi) in humans. Increasing multidrug resistant strains of S. Typhi and limited effect of available vaccines has necessitated exploring of new immunogens for protection against it. Earlier studies have shown that a crude preparation of outer membrane proteins (OMPs) of S. Typhi evokes strong immune response and induces a protective immunity against infection caused by diverse Gram-negative bacteria. In the present study we have evaluated the protective effect of a purified recombinant 49 kDa (r49kDa) OMP of S. Typhi alone or along with alum or complete Freund's adjuvant, against a challenge by S. Typhi (0.4 × 50% lethal dose) by biochemical estimation of serum enzymes and oxidative stress enzymes in Swiss albino mice. There was a decrease in activity of alanine aminotransferase by 14.28%, 38.09%, 23.80%; aspartate aminotransferase by 6.25%, 25%, 16.25%; lipid peroxidation by 4.34%, 18.84%, 11.59%; and catalase by 8%, 14%, 10%, respectively, whereas increase in activity of reduced glutathione by 33.33%, 61.11%, 44.44%; glutathione peroxidase by 7%, 16%, 10%; and glutathione reductase by 8%, 20%, 12%, respectively, as compared to control animals challenged with bacteria without pre-immunization. The results indicated that immunization of mice with r49kDa OMP alone or in combination with adjuvants protected and normalized the liver. It reduces the development of oxidative stress in mice against Salmonella infection and the risk of getting typhoid. These results represent an additional supplement to our earlier reported data on protective immunity evoked by this protein.

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“…41 A rather uncommon complication of enteric fever may occur in the form of multi-organ involvement with disseminated intravascular coagulation, which can present with lower gastrointestinal tract bleeding and is potentially fatal. 42…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Features in Enteric Fever

Hennedige

Bindl

Bhasin

et al. 2012

Ann Acad Med Singap

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Introduction: Enteric fever is a common infection in endemic areas; however, there are few reports describing the computed tomography (CT) manifestations of enteric fever. We aim to describe and illustrate CT findings in enteric fever in this study. Materials and Methods: A retrospective search of medical records in our institute for patients with positive blood cultures for Salmonella typhi, and Salmonella paratyphi organisms yielded 39 cases. Among these patients, 12 had undergone a CT study of the abdomen. The CT images, laboratory and clinical findings of these 12 patients were reviewed. Results: The most common clinical presentation was fever (100%). Typical features of gastroenteritis were present in only over half of the patients. Liver function tests were abnormal in all patients. The most common abdominal manifestations on CT were the presence of mesenteric lymphadenopathy and splenomegaly (75%). Other features were circumferential small bowel wall thickening (58.3%) and free intraperitoneal fluid (50%). Three patients were found to have complications; one with bleeding from terminal ileal ulceration, another with an ileal perforation and the third with renal abscess formation. Conclusion: CT is useful in evaluating enteric fever in patients with severe forms of presentation, a longer clinical course or less specific symptoms. Although the imaging features overlap with other abdominal infections, when combined with clinical features, travel history to endemic areas and presence of transaminitis, the diagnosis of enteric fever should be considered. CT in particular, is useful for the detection of complications such as perforation, bleeding and abscess formation. Key words: Salmonella infections, Imaging, Typhoid, Paratyphoid

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Typhoid fever complicated by multiple organ involvement: report of two cases

Cited by 7 publications

References 22 publications

Sepsis and disseminated intravascular coagulation are rare complications of typhoid fever: A case report

Sepsis and disseminated intravascular coagulation are rare complications of typhoid fever: A case report

Protection against experimental salmonellosis by recombinant 49 kDa OMP of Salmonella enterica serovar Typhi: biochemical aspects

Computed Tomography Features in Enteric Fever

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