Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case Series
Enteric Fever (Typhoid and Paratyphoid fever) is an illness that presents with marked pyrexia, abdominal pain and other gastrointestinal symptoms. Symptoms and complications primarily involve gut. But sometimes it involves other organ systems like heart, and brain. It thus poses a great diagnostic c...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2022-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/17185/59841_CE(Vi)_F(KR)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdf |
| _version_ | 1828057185938046976 |
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| author | Somnath Maitra Kaushik Hazra Sunetra Roy |
| author_facet | Somnath Maitra Kaushik Hazra Sunetra Roy |
| author_sort | Somnath Maitra |
| collection | DOAJ |
| description | Enteric Fever (Typhoid and Paratyphoid fever) is an illness that presents with marked pyrexia, abdominal pain and other gastrointestinal symptoms. Symptoms and complications primarily involve gut. But sometimes it involves other organ systems like heart, and brain. It thus poses a great diagnostic challenge in diagnosing these extraintestinal manifestations. The three cases depicted in this case series had unusual presentations in the form of dilated cardiomyopathy, non haemophagocytic lymphohistiocytosis (HLH) dyslipidaemia and encephalopathy. The first case is a case of reversible cardiomyopathy in a 26-year-old male presenting with fever for seven days with headache, loose motions and vomiting with audible S3 and bibasal crepitations without oedema. The patient responded to ceftriaxone and azithromycin. On echocardiography dilated cardiomyopathy was diagnosed after which treatment with ramipril and metoprolol was started. The second case was of a 30-year-old female presenting with fever, vomiting, and abdominal pain. There was hypertriglyceridaemia with normal ferritin levels. The patient responded to ceftriaxone. High Density Lipoprotein (HDL) level was low. Statin and fenofibrates were added after which the triglyceride levels came down. This was an interesting case of non-HLH dyslipidaemia which responded to therapy. The third case was of a 40-year-old female presenting with fever for six days with impairment of consciousness. Bilateral plantar responses were extensor and there was no papilledema or any cranial nerve palsy. Magnetic Resonance Imaging (MRI) Brain and Cerebrospinal Fluid (CSF) study were normal. The patient responded to ceftriaxone and dexamethasone proving beneficial effects of steroids in enteric encephalopathy. The purpose of the case series was to make clinicians aware of these uncommon presentations of a common disease so that early diagnosis and treatment with Anti Salmonella antibiotics can be initiated quickly to prevent complications. |
| first_indexed | 2024-04-10T21:08:33Z |
| format | Article |
| id | doaj.art-37c1d993bf3d4c55b7940503f155a0b8 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T21:08:33Z |
| publishDate | 2022-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-37c1d993bf3d4c55b7940503f155a0b82023-01-21T11:06:23ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-12-011612OR01OR0410.7860/JCDR/2022/59841.17185Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case SeriesSomnath Maitra0Kaushik Hazra1Sunetra Roy2Associate Professor, Department of General Medicine, Jagannath Gupta Institute of Medical Sciences and Hospital, Budge, West Bengal, India.Assistant Professor, Department of General Medicine, Jagannath Gupta Institute of Medical Sciences and Hospital, Budge, West Bengal, India.Senior Resident, Department of Paediatrics, Jagannath Gupta Institute of Medical Sciences and Hospital, Budge, West Bengal, India.Enteric Fever (Typhoid and Paratyphoid fever) is an illness that presents with marked pyrexia, abdominal pain and other gastrointestinal symptoms. Symptoms and complications primarily involve gut. But sometimes it involves other organ systems like heart, and brain. It thus poses a great diagnostic challenge in diagnosing these extraintestinal manifestations. The three cases depicted in this case series had unusual presentations in the form of dilated cardiomyopathy, non haemophagocytic lymphohistiocytosis (HLH) dyslipidaemia and encephalopathy. The first case is a case of reversible cardiomyopathy in a 26-year-old male presenting with fever for seven days with headache, loose motions and vomiting with audible S3 and bibasal crepitations without oedema. The patient responded to ceftriaxone and azithromycin. On echocardiography dilated cardiomyopathy was diagnosed after which treatment with ramipril and metoprolol was started. The second case was of a 30-year-old female presenting with fever, vomiting, and abdominal pain. There was hypertriglyceridaemia with normal ferritin levels. The patient responded to ceftriaxone. High Density Lipoprotein (HDL) level was low. Statin and fenofibrates were added after which the triglyceride levels came down. This was an interesting case of non-HLH dyslipidaemia which responded to therapy. The third case was of a 40-year-old female presenting with fever for six days with impairment of consciousness. Bilateral plantar responses were extensor and there was no papilledema or any cranial nerve palsy. Magnetic Resonance Imaging (MRI) Brain and Cerebrospinal Fluid (CSF) study were normal. The patient responded to ceftriaxone and dexamethasone proving beneficial effects of steroids in enteric encephalopathy. The purpose of the case series was to make clinicians aware of these uncommon presentations of a common disease so that early diagnosis and treatment with Anti Salmonella antibiotics can be initiated quickly to prevent complications.https://www.jcdr.net/articles/PDF/17185/59841_CE(Vi)_F(KR)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdfdilated cardiomyopathydyslipidaemiaencephalopathynon haemophagocytic lymphohistiocytosisreversible cardiomyopathy |
| spellingShingle | Somnath Maitra Kaushik Hazra Sunetra Roy Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case Series Journal of Clinical and Diagnostic Research dilated cardiomyopathy dyslipidaemia encephalopathy non haemophagocytic lymphohistiocytosis reversible cardiomyopathy |
| title | Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case Series |
| title_full | Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case Series |
| title_fullStr | Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case Series |
| title_full_unstemmed | Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case Series |
| title_short | Variable Presentations of Enteric Fever, beyond Fever and Pain Abdomen: A Case Series |
| title_sort | variable presentations of enteric fever beyond fever and pain abdomen a case series |
| topic | dilated cardiomyopathy dyslipidaemia encephalopathy non haemophagocytic lymphohistiocytosis reversible cardiomyopathy |
| url | https://www.jcdr.net/articles/PDF/17185/59841_CE(Vi)_F(KR)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdf |
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