Pancreatic disturbances and typhoid fever

Abstract

During an 8-year period, 14 adult patients were hospitalized with typhoid fever confirmed by positive blood cultures for Salmonella typhi. Among these patients, we have retrospectively (n = 7) and prospectively (n = 7) evaluated pancreatic disturbance by serum amylase and lipase measurements at the time of admission. In 7 (50%) biological signs of pancreatitis were noted: mean amylase level 81 IU (range 30-201 IU, normal value less than 40 IU), mean lipase level 949 IU (range 468-2,000 IU, normal value less than 300 IU). Clinical signs of pancreatitis were observed in 4 cases, one of whom had a concomitant salmonella biliary tract infection and gall stones demonstrated by laparotomy and the others a normal biliary ultrasonographic examination with a swelling of the pancreas. No alcohol or drug use or other infection were noted before admission. This study suggests that biological or clinical pancreatitis should be considered as a frequent complication of typhoid fever. S. typhi should therefore be added to the list of pathogens implicated in the pathogenesis of non-alcoholic or non-lithiasic pancreatitis.

Mysterious Looks of Typhoid Fever: A New Experience

“…Enteric fever masquerading as acute pancreatitis is a rare entity 5 . The abnormalities of pancreas that are associated with typhoid fever may include simple biochemical abnormalities such as hyperamylasemia to acute pancreatitis, pancreatic abscess, chronic pancreatitis, pancreatic pseudocyst requiring surgery 6,7 .…”

Enteric Fever Presenting as Acute Pancreatitis

“…Enteric fever masquerading as acute pancreatitis is a rare entity [3]. The abnormalities of pancreas that are associated with typhoid fever may include simple biochemical abnormalities such as hyperamylasemia to acute pancreatitis, pancreatic abscess, chronic pancreatitis, pancreatic pseudocyst requiring surgery [4,5].…”

“…Pancreatic pseudocyst may occasionally be infected by Salmonella typhi [2]. Salmonella typhi is known to localize in injured or damaged tissue or insites of malignancy [3]. Kune and Coster reported a case of pancreatic abscess due to Salmonella typhi who had gallstones; the organism was isolated from the necrotic pancreatic tissue [10].…”

“…Treatment includes aggressive management of both typhoid fever and acute pancreatitis [3]. Treatment with anti-secretory drugs, by reducing the gastric killing of ingested organisms, has been shown to represent a risk factor for severity and mortality, so its administration is strongly discouraged [16].…”

Enteric Myocarditis: A Case Report

“…The two most common complications of enteric fever are intestinal hemorrhage and perforation 21 . Among other complications, pancreatitis and simultaneous acute renal failure and hepatitis, cholangitis, meningism, encephalomyelitis, subclinical disseminated intravascular coagulation, osteomyelitis, arthritis have been reported [22][23][24][25][26] . Early antibiotic therapy has reduced the rate of these systemic complications transforming a previously life threatening illness into a short time febrile illness with negligible fatality.…”