title: Typhoid fever complicated by multiple organ involvement: report of two cases.
abstract: Typhoid fever complicated by multiple organ involvement has been rarely mentioned in the literature. We reported two cases of typhoid fever with several unusual manifestations, including acute renal failure, acute hepatitis, acute pancreatitis, disseminated intravascular coagulation, and lower gastrointestinal bleeding. A renal biopsy in the first case showed no pathological change. Bone marrow biopsy showed focal necrosis of matrix, which might have been due to severe illness. A liver biopsy in the second case showed a predominantly histiocytic proliferation with occasional neutrophilic infiltration in the portal areas and hepatic sinusoids. Focal necrosis, bile duct injury, and multiple eosinophilic bodies were also noted. After appropriate antimicrobial therapy, both patients recovered without any sequelae. The potential of multiple organ involvement is highlighted in typhoid fever, which, on rare occasions, may occur simultaneously in the same patient.
authors.affiliation: Department of Internal Medicine, Chi Mei Medical Center, 901 Chung-Hwa Road, Yung-Kang City, Tainan County 710, Taiwan, ROC.
authors.forename: Guan-Cheng
authors.initials: GC
authors.lastname: Huang
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.forename: Yu-Lun
authors.initials: YL
authors.lastname: Huang
authors.forename: Yin-Ching
authors.initials: YC
authors.lastname: Chuang
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D002439:Cefotaxime / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006505:Hepatitis / Q000209:etiology*; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000209:etiology*; D012485:Salmonella typhi / Q000302:isolation & purification; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D002439:Cefotaxime