Over a 6-year period, we studied 791 patients with multidrug-resistant typhoid fever, of whom 6 6 s individuals (84%) developed neuropsychiatric manifestations. These were: acute confusional state (73 %); myelitis ( 6 % ) ; cerebellitis ( I'%); parkinsonism (.r%); acute psychosis (0.6%); meningo-encephalitis (0.5%); encephalitis (0.25%); sensory motor polyneuropathy, polymyositis, acute schizophrenia and bizarre neurological syndromes (O.T 2% each). Severe parkinsonian rigidity and meningo-encephalitis are associated with significant morbidity but very low mortality (0.5%").
The increased risk of cardiac valve disease in patients treated for Parkinson's disease with cabergoline has raised concerns about the safety of treatment with ergot-derived dopamine agonists in patients with endocrine diseases, especially prolactinoma. Concern is raised because the use of cabergoline was associated in one study with an increased prevalence of moderate tricuspid regurgitation, and in two other studies with mild tricuspid regurgitation. Furthermore, the use of cabergoline was associated with increased frequencies of valvular thickening, calcifications, and increased mitral tenting area.
Summary:Three cases of multidrug-resistant Salmonella typhi infection presenting as spontaneous splenic rupture are presented. One patient died and two recovered completely. This is a previously unreported presentation of typhoid fever.
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