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Acute disseminated encehalomyelitis with typhoid fever

K K Krishna1, D K Mitra, A G Diwan

  • 1Dept. of Medicine, Bharati Vidyapeeth Medical College, Pune, Maharashtra.

The Journal of the Association of Physicians of India
|April 25, 2000
PubMed

Insights

A rare case of typhoid fever presented with neurological symptoms, specifically acute disseminated encephalomyelitis (ADEM). This highlights the diverse and severe neurological complications possible with Salmonella Typhi infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Typhoid fever, caused by Salmonella Typhi, is a significant global health concern.
  • Neurological complications of typhoid fever are uncommon but can be severe.
  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disease of the central nervous system.

Observation:

  • A 45-year-old male presented with fever, headache, altered sensorium, pallor, and lower gastrointestinal bleeding.
  • Laboratory investigations confirmed the diagnosis of typhoid fever.
  • Magnetic resonance imaging (MRI) revealed findings suggestive of acute disseminated encephalomyelitis.

Findings:

  • The patient's clinical presentation and laboratory results indicated concurrent typhoid fever and ADEM.
  • This case demonstrates a rare association between Salmonella Typhi infection and ADEM.
  • The diagnostic challenge lies in differentiating primary neurological disorders from those secondary to systemic infections.

Implications:

  • This case underscores the importance of considering neurological complications in patients with severe typhoid fever.
  • Early recognition and appropriate management of both infection and neurological sequelae are crucial for patient outcomes.
  • Further research into the pathomechanisms linking typhoid fever and ADEM may offer insights into neuroinflammatory processes.

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