Enteric Fever: Diagnostic Dilemma Encountered in Domperidone-Induced Neuroleptic Malignant Syndrome

Enteric fever is a multisystem illness caused by Salmonella Typhi and Salmonella Paratyphi, and it is associated with a spectrum of conditions ranging from minor cases of diarrhea and low-grade fever to a potentially fatal illness that can lead to gastrointestinal (GI) perforation, hemorrhage, central nervous system (CNS) involvement. Neuroleptic malignant syndrome (NMS) is predominantly described as an idiosyncratic reaction to neuroleptic medications. However, it has also been associated with a variety of drugs that reduce dopaminergic activity. In this report, we present the case of a young woman who had enteric fever and was prescribed IV ceftriaxone and domperidone. She subsequently developed NMS secondary to domperidone. We highlight the challenges faced when dealing with two potentially lethal medical conditions presenting concurrently and their overlapping symptoms. The patient was treated for both of the conditions and recovered completely.