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Haemoglobinuric renal failure and typhoid fever.

J K Onwubalili1

  • 1University of Nigeria Teaching Hospital, Enugu.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|January 1, 1988
PubMed
Summary

Typhoid fever can cause severe complications like intravascular hemolysis and acute kidney failure, especially in individuals with G6PD deficiency or malaria. Early diagnosis is crucial for effective treatment of this potentially fatal illness.

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Area of Science:

  • Internal Medicine
  • Infectious Diseases
  • Nephrology

Background:

  • Typhoid fever, a systemic infection caused by Salmonella Typhi, is prevalent in endemic regions.
  • Prompt diagnosis and treatment are essential to prevent severe complications.

Observation:

  • Three patients presented with severe intravascular hemolysis, disseminated intravascular coagulation, hemoglobinuria, and acute renal failure.
  • Initial diagnoses were incorrect, delaying appropriate management.

Findings:

  • Two patients had erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency, a known risk factor for hemolysis.
  • The third patient was diagnosed with Plasmodium falciparum malaria concurrently with typhoid fever.
  • These co-existing conditions likely exacerbated the clinical presentation and complications.

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Implications:

  • In G6PD-deficient individuals or those with malaria in endemic areas, pyrexial illness with hemoglobinuric renal failure should raise suspicion for typhoid fever.
  • This highlights the importance of considering typhoid fever in the differential diagnosis of acute febrile illness with renal complications.
  • Accurate and timely diagnosis of typhoid fever is critical to prevent life-threatening outcomes.