Typhoid fever as a cause of opportunistic infection: case report.
BACKGROUND
Typhoid fever is a systemic infection caused by the bacterium Salmonella enterica subspecies enterica serotype typhi, which is acquired by ingestion of contaminated food and water. Each year the disease affects at least 16 million persons world-wide, most of whom reside in the developing countries of Southeast Asia and Africa. In Italy the disease is uncommon with a greater number of cases in Southern regions than in Northern ones.


METHODS
We report on a 57-year-old Sri-Lankan male affected by typhoid fever, the onset of which was accompanied by oropharyngeal candidiasis. This clinical sign was due to a transient cell-mediated immunity depression (CD4+ cell count was 130 cells/mm3) probably caused by Salmonella typhi infection. Human immunodeficiency virus infection was ruled out. Diagnosis of typhoid fever was made by the isolation of Salmonella typhi from two consecutive blood cultures. The patient recovered after a ten days therapy with ciprofloxacin and his CD4+ cell count improved gradually until normalization within 3 weeks.


CONCLUSIONS
Our patient is the first reported case of typhoid fever associated with oropharyngeal candidiasis. This finding suggests a close correlation between Salmonella typhi infection and transitory immunodepression.
Colomba
Claudia
C
Istituto di Patologia Infettiva e Virologia, Università di Palermo, Piazza Montalto 8, 90134 Palermo, Italy. claudia.colomba@libero.it
Saporito
Laura
L
Infurnari
Laura
L
Tumminia
Salvatore
S
Titone
Lucina
L
D000890:Anti-Infective Agents / Q000627:therapeutic use; D002180:Candidiasis, Oral / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology*; D013188:Sri Lanka; D014435:Typhoid Fever / Q000150:complications* / Q000188:drug therapy
D000890:Anti-Infective Agents