Salmonellosis complicating schistosomiasis in the Sudan

Salmonella typhi or Paratyphi A was isolated from the blood in 16 out of 21 Suanese patients who had prolonged fever of one of 10 months' duration and hepatesplenic schistosomiasis. Most patients had severe anaemia. The serum alkaline phosphatase was raised in 16 patients. Bilharzial lesions were demonstrated in the liver biopsies of 10 patients. Three patients had in addition the nephrotic syndrome and moderate proteinuria was present in nine other patients. Changes of proliferative glomerulonephritis were noted in the renal biopsies of two patients with the nephrotic syndrome. Treatment with chloramphenicol cured the salmonella infection in all patients, reversed the raised alkaline phosphatase and the proteinuria, and led to a marked reduction in the size of the hepatosplenomegaly.