Typhoid fever presenting as a depressive disorder--a case report.
BACKGROUND
Neuropsychiatric complications associated with typhoid fever are relatively common in the tropics; however, typhoid fever with associated depression is rare and can present a diagnostic challenge to rural clinicians.


OBJECTIVE
This case report describes a 12 year old female with no documented psychiatric history who developed signs and symptoms of delirium with depressive elements while also infected with typhoid fever. At the time of presentation to a community health centre in Abeokuta, Nigeria, the patient had been misdiagnosed as suffering from primary psychiatric morbidity and therefore mismanaged. Following investigation and appropriate therapy she made a complete recovery.


CONCLUSIONS
A rural physician working in an area with an inadequate safe water supply can expect to encounter several cases of typhoid fever with neuropsychiatric presentation. In order to make a correct diagnosis clinicians must maintain a high index of suspicion of primary medical morbidity in patients presenting with depressive features associated with a febrile illness.
Ukwaja
Kingsley N
KN
Family Health Centre, Abeokuta, Ogun, Nigeria. ukwajakingsley@yahoo.co.uk
D000890:Anti-Infective Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002648:Child; D002746:Chlorpromazine / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D014435:Typhoid Fever / Q000175:diagnosis* / Q000188:drug therapy
D000890:Anti-Infective Agents; D014150:Antipsychotic Agents; D008795:Metronidazole; D002939:Ciprofloxacin; D002746:Chlorpromazine