Diagnostic bias during the COVID-19. A rare case report of salmonella typhi

Abstract

Introduction In poor countries, due to the limited resources, mostly they prescribe medications without proper diagnosis. The aim of this report is to show diagnostic bias of COVID-19 case. Case presentation A 17-year-old male patient was presented to the Hospital with a fever up to 39 °C associated with rigor, sweating, generalized body pain, myalgia, fatigue, loss of appetite, headache, and multiple joint pain with no swelling and redness. The vital signs were steady on physical examination, except temperature which was 39 °C. The chest was clear, and the pulse rate was 90 beats per minute. The heart rate relative bradycardia and lungs were normal. Both a PCR test for COVID-19, and a viral assay ELISA were negative. After further investigations, the culture findings revealed the strong development of Gram-negative coccobacilli ( Salmonella serotype Typhi) bacteria under the microscope, which was confirmed by using VITEK 2 to identify it. and treated with ciprofloxacin tab, two times per day for five days and amikacin ampule 500 mg IV every 24 hours for 10 days. Discussion Fever is a well-known sign of COVID-19 infection which has been observed in 83%–98% of patients with COVID19. As a result, it may be difficult to tell the difference between COVID-19 and other febrile infections, causing delays in diagnosis and treatment and may blind the physician from considering other febrile illnesses. Conclusion Physicians should construct more comprehensive differential diagnoses for people who experience fever, headache, or myalgia symptoms that are linked to a pandemic. COVID-19.

Concurrent emergencies: overlapping Salmonella and COVID-19 concerns in public health strategies and preparedness

“…Nevertheless, the symptoms associated with the SARS-CoV-2 virus, such as fever, headache, reduced appetite, muscular discomfort, and gastroenteritis (nausea and diarrhea), have a remarkable resemblance to those observed in Salmonella infections, including both typhoid and non-typhoid strains ( 9 ). This recurring overlap of symptoms between these pathogens during the COVID-19 pandemic made it challenging to accurately identify Salmonella , giving rise to diagnostic bias in clinical settings ( 5 ). Additionally, according to Ürkmez and Atalay ( 1 ) as well as Haqqi et al ( 13 ), the simultaneous occurrence of COVID-19 and Salmonella infections presents significant challenges in the planning of clinical treatment ( 8 , 26 ).…”

“…Utilizing precise and reliable diagnostic techniques is crucial for making succinct decisions while dealing with these overlapping symptoms. Accurate identification of pathogens implicated in illnesses is crucial for effective treatment ( 5 , 14 ). Conversely, inadequate treatment might exacerbate the condition for both the patient and the whole scenario.…”

“…Moreover, the distribution of research and development resources has exhibited an imbalanced focus on COVID-19, while certain illnesses, such as recurrent Salmonella infections, received much less emphasis and scrutiny ( 5 ). It was leading to a postponement in progress related to other infectious diseases ( 40 , 41 ).…”

“…As a result of the COVID-19 pandemic, healthcare has redirected its focus toward detecting the SARS-CoV-2 virus, primarily in clinical settings. These alterations in clinical diagnostic emphasis, therefore, exclude the possibility of diagnosing other infectious disorders, such as those caused by Salmonella ( 5 ). The widespread enforcement of strict lockdown measures worldwide during the COVID-19 pandemic restricted individual and societal activities.…”

“…Although Salmonella infection and COVID-19 have different modes of transmission, they exhibit comparable symptoms ( 9 ). The misreading of this circumstance, along with the shift in diagnostic focus, amplifies the bias in estimating the incidence of Salmonella infections ( 5 ). Additionally, it is essential to note that the immunological response that SARS-CoV-2 elicits may have affected the severity of bacterial infections like Salmonella ( 10 ).…”