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Severe reversible myopathy due to typhoid.

G M Mody1, V Gathiram, E A Abdulla

  • 1Department of Medicine, King Edward VIII Hospital, Durban, South Africa.

The Journal of Tropical Medicine and Hygiene
|April 1, 1989
PubMed
Summary

A rare case of typhoid fever complicated by severe myopathy in an 18-year-old male is presented. Prompt antibiotic treatment led to full recovery, highlighting a seldom-seen neurological complication of this infection.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Biochemistry

Background:

  • Typhoid fever, caused by Salmonella Typhi, commonly presents with fever and gastrointestinal symptoms.
  • Neuropsychiatric manifestations are known but infrequent complications of typhoid fever.
  • Proximal myopathy is a severe muscle condition characterized by weakness in the muscles closest to the center of the body.

Observation:

  • An 18-year-old male presented with fever and profound proximal myopathy, rendering him unable to walk.
  • Laboratory tests revealed marked elevation in creatine phosphokinase (CPK) and myoglobinuria, indicating significant muscle damage.
  • The patient was diagnosed with typhoid fever.

Findings:

  • Antibiotic therapy for typhoid fever resulted in the normalization of creatine phosphokinase levels.
  • The patient experienced a complete clinical recovery from the myopathy.
  • This case highlights a rare presentation of typhoid fever involving significant muscle injury.

Implications:

  • This case underscores the importance of considering myopathy as a potential complication in typhoid fever, even in the absence of typical neurological symptoms.
  • Monitoring creatine phosphokinase levels may be beneficial in patients with severe typhoid fever presenting with muscle weakness.
  • Further research is warranted to understand the pathophysiology linking typhoid infection to myopathy and to establish diagnostic and management guidelines for this rare complication.

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