A Rare Case of Aplastic Anemia in Toxic Typhoid Fever
Abstract
Introduction and importance: Typhoid fever is one of the representative febrile diseases in the tropics, with unhygienic environmental conditions and poor public health systems. Pancytopenia from hemophagocytic lymphohistiocytosis is a rare complication of typhoid fever, which may be fatal if untreated. Presentation of case: A 20-year-old woman presented to our tertiary care center with high-grade fever, body pain, and slurring of speech. Investigations showed pancytopenia, TUBEX IgM Salmonella test positive, lymphadenopathy, and peripheral blood smear showed aplastic anemia after ruling out other possibilities and diagnostics. The patient responded to culture-sensitive antibiotics, steroids, and supportive care. Discussion: Pancytopenia in typhoid fever patients is linked to the mechanism of HLH (Hemophagocytic lymphohistiocytosis). Conclusion: It is essential to diagnose and treat toxic typhoid fever with an appropriate antibiotic to prevent complications.
References
1. WHO (2018) ‘Typhoid vaccine: WHO position paper - March 2018’, Weekly Epidemiological Record, 13(93), pp. 153–172.
2. Ndako, J. A. et al. (2020) ‘Changes in some hematological parameters in typhoid fever patients attending Landmark University Medical Center, Omuaran-Nigeria,' Heliyon, 6(5), p. e04002. doi: 10.1016/j.heliyon.2020.e04002.
3. Parry, C. M. et al. (2014) 'Risk factors for the development of severe typhoid fever in Vietnam,' BMC Infectious Diseases, 14(1), pp. 1–9. doi: 10.1186/1471-2334-14-73.
4. Perin, M. E., Kanna, S. and Sai, V. (2022) 'Unusual Presentation of Typhoid Fever,' Journal of Research in Medical and Dental Science, 10(7), pp. 134–136.
5. Shin, B. M., Paik, I. K. and Cho, H. I. (1994) 'Bone marrow pathology of culture-proven typhoid fever.' Journal of Korean Medical Science, pp. 57–63. doi: 10.3346/jkms.1994.9.1.57.
6. Pilonieta, M. C. et al. (2014) ‘Salmonella Enterica infection stimulates macrophages to hemophagocytose’, mBio, 5(6), pp. 1–14. doi: 10.1128/mBio.02211-14.
7. Shekhar S, Radhakrishnan R, Nagar VS. Secondary Hemophagocytic Lymphohistiocytosis Due to Typhoid Fever. Cureus. 2023 Jul 20;15(7):e42175. doi: 10.7759/cureus.42175. PMID: 37602057; PMCID: PMC10439506.
8. Non, L. R. et al. (2015) ‘Case report: Typhoid fever complicated by hemophagocytic lymphohistiocytosis and rhabdomyolysis,' American Journal of Tropical Medicine and Hygiene, 93(5), pp. 1068–1069. doi: 10.4269/ajtmh.15-0385.
9. M., Stephens, G. and McMullan, B. (2016) 'Severe thrombocytopenia in a child with typhoid fever: a case report,' Journal of Medical Case Reports, 10(1), pp. 1–4. doi: 10.1186/s13256-016-1138-6.
10. Tam FCH, Ling TKW, Wong KT, Leung DTM, Chan RCY, Lim PL. The TUBEX test detects not only typhoid-specific antibodies but also soluble antigens and whole bacteria. J Med Microbiol. 2008 Mar;57(Pt 3):316-323. doi: 10.1099/jmm.0.47365-0. PMID: 18287294.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 MUTIARA PUTRI NOVITA NOVITA, Irma Zaimatuddunia
This work is licensed under a Creative Commons Attribution 4.0 International License.
