Acute renal failure and typhoid fever

Over a two-year period, out of 40 adult Ghanaians admitted to the renal unit of Korle Bu Hospital with acute renal failure, 6 (15%) had typhoid fever. During this period approximately 500 cases of typhoid were admitted to this Hospital. Prominent features in these cases were a blackwater fever syndrome and leucocytosis. These features in a patient with typhoid should suggest the possibility of complicating acute renal failure. Three patients showed a deficiency of glucose-6-phosphate dehydrogenase (G-6-P.D.) in their red blood cells. It is suggested that typhoid is likely to be an important cause of acute renal failure in areas where it is endemic and G-6-P.D. deficiency common.