Typhoid Fever goes rogue: A rare & unusual case of concurrent typhoid hepatitis and splenic abscess in an immunocompetent adult

伤寒失控:免疫功能正常的成年人同时发生罕见的伤寒性肝炎和脾脓肿病例

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Abstract

SUMMARY: This case report describes a rare instance of simultaneous typhoid hepatitis and splenic abscess in a 27-year-old immunocompetent male from India. The patient presented with high fever, jaundice, abdominal pain, and vomiting, and was mimicking acute viral hepatitis or disseminated tuberculosis finally diagnosed with Salmonella typhi infection following extensive diagnostic & therapeutic evaluations. Despite the seriousness of hepatic and splenic involvement, especially in the absence of underlying immunodeficiency, the patient responded well to appropriate antibiotic therapy. The report highlights the diagnostic challenges and clinical significance of atypical typhoid complications, emphasizing the importance of timely recognition and treatment to improve outcomes. INTRODUCTION: In India, infection with Salmonella typhi, causing typhoid fever, is quite common. This may sometimes mimic other infectious diseases, complicating the diagnosis and management of these patients. Typhoid fever is a multisystem illness transmitted by the Feco-oral route, primarily through contaminated water and undercooked food, caused by Salmonella typhi and Salmonella paratyphi. It carries an important health concern, especially in tropical and developing countries. [1], [2] The gastrointestinal complications related to Salmonella typhi infection are Ileal perforation/ulceration, and may lead to obstruction and have been commonly reported. [1] Apart from that, involvement of the liver and spleen in typhoid fever is a serious concern. Here we are representing a case that presented with typhoid hepatitis and typhoid splenic abscess.

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