Catatonia and parkinsonism as a sequelae of typhoid fever: a rare experience

Abstract

Although neurological manifestations of typhoid fever was thought to be obsolete from modern world, emergence of multidrug resistant typhoid bacilli and reporting of outbreak of typhoid fever with a range of early neuropsychiatric manifestations from various parts of world has led clinicians and investigators to re-evaluate the clinical spectrum of this endemic sinister disease. An 18-year-old male student was admitted in psychiatry ward with mutism, staring look, posturing and rigidity. There was history of typhoid fever 1 week before for which he was prescribed cefuroxime. Although investigations fail to provide any clue, his catatonic symptoms disappeared 2 weeks later giving way to resting tremor, bradykinesia, cog-wheel rigidity but without gait abnormality. He was successfully treated with lorazepam, amantidine, olanzapine and pramiprexole. The patient was asymptomatic within a month. He had no recurrence of symptoms till last follow-up, 6 months from the illness.

Salmonella Typhimurium Infection Leads to Colonization of the Mouse Brain and Is Not Completely Cured With Antibiotics

“…Typhoid fever is commonly characterized by headache, stomach pain and a sustained high fever. In rare cases, typhoid fever patients have been found to exhibit neurological abnormalities (Dewan et al, 2009 ; Joshi et al, 2011 ; Szabo et al, 2013 ; Talukdar et al, 2013 ). A very high mortality rate, more so in infants, is associated with Salmonella infections of the brain (Drevets et al, 2004 ).…”

Parkinsonism and Brain Mri Findings in a Relapsed Culture-Proven Salmonella Typhi Infection: A Case Report in Malaysia

“…Previous studies have reported various features from MRI investigation, ranging from normal appearance, demyelinating changes, symmetrical diffuse abnormal signal with central area of restricted diffusion to diffuse cerebral oedema (10)(11)(12)(13). The literature on imaging findings of Parkinsonism is lacking.…”

“…The literature on imaging findings of Parkinsonism is lacking. Talukdar et al reported a normal appearance on MRI in a patient with catatonia and Parkinsonism (13), however, the MRI was done prior to the onset of Parkinsonism. To the best of our knowledge, this is the first case report demonstrating the MRI findings in a patient with typhoid fever and Parkinsonism.…”

“…A recent case report indicated that a combination of amantadine and dopamine agonist resulted in a complete recovery of symptoms within a month of treatment (13). High-dose intravenous methylprednisolone has also been shown to be successful in treating patients with salmonella-associated encephalopathy (11); however, its benefit in Parkinsonism is yet to be evaluated.…”

Relapse of typhoid fever following delayed response to meropenem: A case report and review of previously published cases indicating limited clinical efficacy of meropenem for the treatment of typhoid fever

“… relapse (14 days up to 3 months following treatment) [ 4 ]; psychiatric disorders [ 20 ]; neurologic disorders [ 21 ], [ 22 ], [ 23 ]; ophthalmologic disorders [ 24 ]; intracranial abscess (47 years following typhoid fever) [ 25 ]; atrophic rhinitis [ 26 ]. …”