[Septic shock with coma revealing typhoid fever].
BACKGROUND
Typhoid fever may be difficult to distinguish from malaria. Septic shock, encephalopathy and leukopenia are common features of both diseases.


METHODS
A 20-year-old South Korean woman was admitted to the intensive care unit with coma and shock. Vomiting and abdominal pain were followed by headache, prostration, fever and diarrhea. Leukocytopenia, lymphocytopenia, thrombocytopenia, rhabdomyolysis and hepatitis were present. Clotting tests were normal. The thick peripheral blood film was negative. Salmonella typhi was isolated from 6 blood cultures. Treatment associated ceftriaxone 4 g per day for 5 days, colloid and crystalloid fluids and dopamine. The patient was discharged 2 weeks later.


CONCLUSIONS
Typhoid fever should be considered as a diagnosis in patients with sepsis who come from endemic zones. Abdominal symptoms, prolonged fever, coma and delayed headache are particularly contributive signs. Specific treatment should be instituted.
Service de Réanimation médicale, CHU Bretonneau, Tours.
E
E
Hazouard
M
M
Ferrandière
B
B
Cattier
P F
PF
Dequin
A
A
Legras
G
G
Giniès
D000328:Adult; D002443:Ceftriaxone / Q000627:therapeutic use; D003128:Coma / Q000209:etiology*; D003422:Critical Care; D003937:Diagnosis, Differential; D004298:Dopamine / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007723:Korea; D012485:Salmonella typhi / Q000302:isolation & purification*; D012772:Shock, Septic / Q000209:etiology*; D014435:Typhoid Fever / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
D002443:Ceftriaxone; D004298:Dopamine
Choc septique avec coma révélateur d'une fièvre typhoïde.