Cholestatic hepatitis in a patient with typhoid fever - a case report

Ratnayake, Eranda C; Shivanthan, Chrishan; Wijesiriwardena, Bandula

doi:10.1186/1476-0711-10-35

Cited by 17 publications

(10 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Usually, typhoid fever presents with continual fever, accompanied by increasing fatigue, abdominal distension, constipation, abdominal pain, frontal headaches, malaise, anorexia, nausea and vomiting [ 14 , 15 ]. Later in the disease course the patient may present with jaundice due to elevated conjugated bilirubin as a result of endotoxin induced cholestasis [ 16 ]. All these features appeared in the present case at the district hospital.…”

Section: Discussionmentioning

confidence: 99%

Salmonella Typhi meningitis in a 9-year old boy with urinary schistosomiasis: a case report

et al. 2015

View full text Add to dashboard Cite

BackgroundCases of Salmonella Typhi meningitis have been rarely reported in infants. There are few documented cases of persistent salmonella bacteraemia in patients with schistosomiasis. A presented case highlights the importance of broadening the list of pathogens that can cause meningitis among older children in schistosomiasis endemic regions.Case presentationThe reported case is of a 9-year old sukuma-black African boy referred to Bugando Medical Centre with complaints of fever, abdominal pain, headache and generalized body weakness. On examination; the child was febrile (39°C) with neck stiffness and distended abdomen. Cerebrospinal fluid culture was positive for Salmonella Typhi. In addition on urine sediments microscopy, Schistosoma haematobium eggs were seen. The child improved clinically on ceftriaxone and praziquantel, and was discharged 3 weeks after admission.ConclusionComplicated persistent salmonella infection should be considered in schistosomiasis endemic areas. More research should be done to confirm the association between salmonella infections and urinary schistosomiasis.

show abstract

Section: Discussionmentioning

confidence: 99%

Salmonella Typhi meningitis in a 9-year old boy with urinary schistosomiasis: a case report

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Possible risk factors for development of typhoid hepatitis include the virulence of S. typhi, poor functional status of the patient with comorbidities, and delayed start of treatment [24]. Typhoid hepatitis also has been suggested to increase the risk of relapse of typhoid fever [22]. The standard of care for cholestatic hepatitis, has been the administration of appropriate antibiotics according to the bacterial susceptibility [25].…”

Section: Discussionmentioning

confidence: 99%

“…This manifests as variable elevation in serum bilirubin, liver transaminases, GGT or ALP. Picture is usually cholestatic, however, symptomatic cholestatic hepatitis is rare and there are only a few case reports [ 20 , 22 - 23 ]. Hepatomegaly was seen in 2% (2/10) with nonresistant typhoid fever, 14% (1/7) with MDR typhoid, and 18% (7/39) of our patients with XDR typhoid (p=0.96).…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal and Hepatobiliary Complications of Extensively Drug-Resistant Typhoid at a Tertiary Care Hospital in Pakistan

Mansoor¹,

Ahmed²,

Fida³

et al. 2020

Cureus

View full text Add to dashboard Cite

Introduction: Typhoid fever is a major health problem in developing countries. Extensively drug-resistant (XDR) typhoid is an emerging threat to world health. The objectives of this study were to report our blood culture proven patients having XDR typhoid and compare the rate of gastrointestinal (GI) and hepatobiliary manifestations and complications of antimicrobial sensitive and resistant strains. Materials and methods: This prospective observational study was carried out at a tertiary care hospital in Pakistan, from January 2019 till August 2020 on all consecutive blood culture proven patients of Salmonella typhi. A total of 57 cases of Salmonella were identified, of which 10 were nonresistant, seven multi drugresistant (MDR), 39 extensively drug-resistant (XDR), and one was extended-spectrum beta lactamase (ESBL) positive. Alarmingly, one of the S. typhi isolate in addition to the first line drugs, was also resistant to azithromycin. Patients were treated with antibiotics according to antimicrobial susceptibility of the Salmonella in accordance with the World Health Organization (WHO) and Medical Microbiology and Infectious Diseases Society of Pakistan (MMIDSP) guidelines and GI and hepatobiliary complications were recorded. Results: Overall rate of complications was low. Some 10% (1/10) with nonresistant typhoid, 14% (1/7) with MDR, and 15% (6/39) of our patients with XDR typhoid fever had abdominal tenderness (p=0.95). None of the patients had GI bleeding, abdominal abscess, or peritonitis. Some 20% (2/10) patients with nonresistant typhoid, 29% (2/7) with MDR, and 18% (7/39) with XDR typhoid developed acute hepatitis, with greater than three times elevation of liver transaminases. There was no statistically significant difference in the occurrence of hepatitis between these groups (p=0.98). Interestingly, one of our patients with XDR typhoid also developed cholestatic hepatitis. Conclusion: There is no significant difference in GI and hepatobiliary complications amongst antimicrobial sensitive and resistant strains of typhoid. However, emergence of resistant strains calls for focus on prevention and judicious use of antimicrobials.

show abstract

“…A minority of patients with typhoid fever can develop cholestatic hepatitis, the pathogenic mechanism being unknown (Arabaci et al 2003;Albayrak et al 2011;Ratnayake et al 2011). …”

Section: Cholestatic Typhoid Hepatitismentioning

confidence: 98%

Liver Abscesses as Pseudotumoral Lesions

Zimmermann¹

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

View full text Add to dashboard Cite

Cholestatic hepatitis in a patient with typhoid fever - a case report

Cited by 17 publications

References 4 publications

Salmonella Typhi meningitis in a 9-year old boy with urinary schistosomiasis: a case report

Salmonella Typhi meningitis in a 9-year old boy with urinary schistosomiasis: a case report

Gastrointestinal and Hepatobiliary Complications of Extensively Drug-Resistant Typhoid at a Tertiary Care Hospital in Pakistan

Liver Abscesses as Pseudotumoral Lesions

Contact Info

Product

Resources

About