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Typhoid fever presenting with gastric ulcer bleeding
Hong Jae Jeon1,2, Jong Seo Lee3,2, Byung Seok Lee3,2
1Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Sejong Hospital, 20, Bodeum 7-ro, Sejong, 30099, Republic of Korea.
BMC Gastroenterology
|March 11, 2022
Summary
Enteric fever, caused by Salmonella Typhi, can rarely lead to upper gastrointestinal bleeding from gastric ulcers. Early suspicion of GI bleeding is crucial, especially with recurring Salmonella infections.
Area of Science:
- Gastroenterology
- Infectious Diseases
Background:
- Enteric fever, caused by Salmonella enterica serovar Typhi (Salmonella Typhi) or Paratyphi, is a systemic illness.
- While typically responsive to antibiotics, complications like intestinal hemorrhage can occur.
- Upper gastrointestinal bleeding is an uncommon complication of enteric fever.
Observation:
- A case of a 32-year-old woman presenting with fever, abdominal pain, and melena.
- Gastroscopy revealed active gastric ulcers with hemorrhagic spots.
- Salmonella Typhi was identified in blood cultures, and the patient experienced recurrent fever and bacteremia.
Findings:
- The patient developed active gastric ulcers and upper gastrointestinal bleeding.
- Treatment with ceftriaxone was initiated, and symptoms resolved.
- Recurrent Salmonella Typhi bacteremia occurred post-discharge, necessitating further antibiotic treatment.
Implications:
- This case highlights that active gastric ulcers can manifest in patients with enteric fever.
- Clinicians should consider both upper and lower gastrointestinal bleeding in enteric fever patients.
- Relapsing bacteremia in enteric fever may indicate a higher risk for gastrointestinal complications.
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