title: A patient with paratyphoid A fever: an emerging problem in Asia and not always a benign disease.
abstract: A 15-year-old Nepalese boy with fever was thought to have enteric fever and started on cefixime. His blood culture grew Salmonella paratyphoid A. On the sixth day, he developed gastrointestinal bleeding, disseminated intravascular coagulation, and later, acute respiratory distress syndrome. He succumbed to his illness despite treatment in the intensive care unit with ceftriaxone, intravenous fluids, and mechanical ventilation. Salmonella paratyphoid A, for which there is no commercial vaccine, may not be a benign disease as perceived, and cefixime that is recommended for enteric fever may be an ineffective choice.
authors.affiliation: Clinical Research, Patan Hospital, Lalitpur, Nepal.
authors.forename: Anil
authors.initials: A
authors.lastname: Pandit
authors.forename: Amit
authors.initials: A
authors.lastname: Arjyal
authors.forename: Buddhi
authors.initials: B
authors.lastname: Paudyal
authors.forename: James C
authors.initials: JC
authors.lastname: Campbell
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Day
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Farrar
authors.forename: Buddha
authors.initials: B
authors.lastname: Basnyat
mesh_terms: D000293:Adolescent; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000382:microbiology; D006801:Humans; D008297:Male; D009390:Nepal; D010284:Paratyphoid Fever / Q000150:complications* / Q000175:diagnosis*; D012128:Respiratory Distress Syndrome / Q000382:microbiology*; D012482:Salmonella paratyphi A / Q000302:isolation & purification*