A case of typhoid fever with neurological presentation

Typhoid fever, leading to systemic disease due to Salmonella enterica serotype Typhi, typically has gastrointestinal manifestation, however, neurologic complications-although uncommon, can arise. Aseptic meningitis and optic neuritis are rare manifestations that can be challenging to diagnose.

Our patient a 31-year male presented with fever for 18 days associated with headache, rash, vomiting, diarrhea and progressive neurological symptoms in form of disorientation and blurred vision. On examination there was bilateral sixth cranial nerve palsy. Investigations were positive for typhoid fever with aseptic meningitis and optic neuritis. He was successfully treated with intravenous ceftriaxone and corticosteroids.

Atypical neurological symptoms of typhoid fever must be recognized. To prevent complications, early diagnosis and treatment are important. Typhoid fever should be considered in febrile patients with unexplainable neurological symptoms, especially in an endemic region.