title: Salmonella paratyphi A enteric fever mimicking viral meningitis.
abstract: Enteric fevers are caused by invasive strains of Salmonella. Classic enteric fever is caused by S. typhi and usually less severe enteric fevers are caused by S. paratyphi A, B, or C. We present a case of S. paratyphi A enteric fever aseptic meningitis. Headache was so prominent in the case presented that a lumbar puncture was performed to rule out meningitis. Rose spots were not apparent in this dark-skinned patient. Our patient did not have increased serum transaminases and did not have leukopenia, which are common findings in enteric fever. The absence of these findings and the relative bradycardia may be explained by the antimicrobial therapy the patient received before admission. After ruling out malaria, clinicians should suspect enteric fever in patients recently returning from endemic areas, in patients presenting with acute fevers without localizing signs.
authors.affiliation: Infectious Disease Division, Department of Medicine, Winthrop-University Hospital, Mineola, NY 11501, USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Kudalkar
authors.forename: Marjorie
authors.initials: M
authors.lastname: Thermidor
authors.forename: Burke A
authors.initials: BA
authors.lastname: Cunha
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001919:Bradycardia / Q000139:chemically induced; D003937:Diagnosis, Differential; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008587:Meningitis, Viral / Q000150:complications / Q000175:diagnosis*; D010284:Paratyphoid Fever / Q000150:complications / Q000175:diagnosis*; D012482:Salmonella paratyphi A
chemical_list: D000900:Anti-Bacterial Agents