Complicated enteric fever: a case series


  • Vijay Kumar Shrivas Department of Medicine, Apollo Hospitals Bilaspur, Chhattisgarh, India
  • Manoj Kumar Rai Department of Medicine, Apollo Hospitals Bilaspur, Chhattisgarh, India
  • Sandhya Chandel Department of Medicine, Apollo Hospitals Bilaspur, Chhattisgarh, India



ARDS, Enteric fever, Encephalopathy, Thrombocytopenia


Enteric fever is endemic in Indian subcontinent. Authors are presenting 3 rare cases of complicated enteric fever. The first case is a case of enteric fever which was complicated by ARDS leading to respiratory failure. The second case is a case of enteric fever which was complicated by severe thrombocytopenia and the third case is a case of enteric fever which was complicated by severe encephalopathy. In this study authors have discussed and compared the similar cases found in India and other parts of the world. The physicians who are taking care of the patients of enteric fever should be aware of the above complications.


Parry CM, Hien TT, Dougen G, White NJ, Farrar JJ. Typhoid Fever. N Engl J Med. 2002;347(22):1770-82.

Vollaard AM, Ali S, Widjaja S. Identification of typhoid fever and paratyphoid fever cases at presentation in OP clinics in Jakarta, Indonesia. Trans R Soc Trop Med Hyg. 2005;99(6):440-50.

Buckle GC, Walker CL, Black RE. Typhoid fever and Paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010. J Glob Health. 2012;2(1):010401.

Dham SK, Thompson RA. Humoral and Cell mediated immune responses in chronic Typhoid carriers. Clin Exp Immunol. 1982;50(1):34-40.

Buczko GB, Lean J. Typhoid fever associated with adult respiratory distress syndrome. Chest. 1994;105(6):1873-4.

Agrawal PN, Ramanathan RM, Gupta D. Acute respiratory distress syndrome complicating typhoid fever. Indian J Chest Dis Allied Sci. 1999;41(4):225-9.

De Silva HJ, Kularatne WS, Wijewickrema R, Thevanesam V. Adult respiratory distress syndrome (ARDS) complicating typhoid fever. J Tropi Med Hygiene. 1993;96(1):64-5.

Dhakad U, Das SK, Srivastav D, Nolkha N. Arthritis and adult respiratory distress syndrome: unusual presentation of typhoid fever. BMJ case Rep. 2014 Oct 21;2014.

Martin TR. Lung cytokines and ARDS. Chest. 1999;116(1supp):2S-8S.

Serefhanoglu K, Kaya E, Sevinc A, Aydogdu I, Kuku I, Ersoy Y. Isolated thrombocytopenia: the presenting finding of typhoid fever. Clini Lab Haematol. 2003 Feb;25(1):63-5.

Al Reesi M, Stephens G, McMullan B. Severe thrombocytopenia in a child with typhoid fever: a case report. J Medical Case Reports. 2016 Dec;10(1):333.

Subhan M, Sadiq W. Case of Enteric fever with Bicytopenia. Cureus. 2017;9(12):e1910.

Charan S, Chander R, Singh I. Isolated thrombocytopenia a rare presenting feature of enteric fever. Int J Adv Med. 2016 Apr;3(2):438.

Khosla SN, Anand A, Simy U. Haematological profile in typhoid fever. Trop Doct. 1995;25(4):156-8.

Sejvar J, Lutterloh E, Naiene J, Likaka A, Manda R, Nygren B, et al. Neurologic manifestations associated with an outbreak of typhoid fever, Malawi-Mozambique, 2009: an epidemiologic investigation. PLoS One. 2012;7(12).

Lakhotia M, Gehlot RS. Neurologic manifestations of enteric fever. JIACM. 2003;4(3):196-9.

Wadia RS, Ichaporia NR, Kiwalkar RS, Amin RB, Sardesai HV. Cerebellar ataxia in enteric fever. J Neurol, Neurosurg Psychiatr. 1985;48(7):695-7.

Kalra OP, Agrawal NK, Agarwal S. Acute reversible cerebellar ataxia in typhoid fever. J Indian Acad Clin Med. 2002;3(1):96-7.

Nair RK, Mehta SR, Kumaravelu S. Typhoid fever presenting as acute psychosis. Med J, Armed Forces India. 2003;59(3):252.

Osuntokun BO, Bademosi O, Ogunremi K, Wright SG. Neuropsychiatric manifestations of typhoid fever in 959 patients. Arch Neurol. 1972;27(1):7-13.






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