Reversible encephalopathy secondary to paratyphoid infection and concomitant acute Hepatitis A

South Med J. 2005 Jul;98(7):723-5. doi: 10.1097/01.smj.0000168134.80038.25.

Abstract

Reversible encephalopathy has been described in association with typhoid fever as well as nontyphoidal salmonella infections. A diagnostic dilemma as to the cause of encephalopathy may arise when there is coexistent acute viral hepatitis and suspicion of fulminant liver failure. The authors report a patient who presented with acute icteric hepatitis A infection and a concomitant febrile illness due to Salmonella paratyphi associated with progressive encephalopathy and coma. The young man developed high-grade fever and coma. Concomitant infection with S. paratyphi was diagnosed and the patient's encephalopathy resolved rapidly with antibiotic therapy. This is the first report of a putative association of S. paratyphi infection and reversible encephalopathy. Salmonella and hepatitis A virus infection are both transmitted via the fecal-oral route, and awareness of this association is important in the management of such patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Coma
  • Hepatic Encephalopathy / drug therapy
  • Hepatic Encephalopathy / etiology*
  • Hepatitis A / complications*
  • Hepatitis A / enzymology
  • Hepatitis A / physiopathology
  • Humans
  • Male
  • Paratyphoid Fever / complications*
  • Paratyphoid Fever / physiopathology
  • Salmonella paratyphi B / isolation & purification*
  • Salmonella paratyphi B / pathogenicity

Substances

  • Anti-Bacterial Agents