Computed tomography features in enteric fever.
BACKGROUND
Enteric fever is a common infection in endemic areas; however, there are few reports describing the computed tomography (CT) manifestations of enteric fever. We aim to describe and illustrate CT findings in enteric fever in this study.


METHODS
A retrospective search of medical records in our institute for patients with positive blood cultures for Salmonella typhi, and Salmonella paratyphi organisms yielded 39 cases. Among these patients, 12 had undergone a CT study of the abdomen. The CT images, laboratory and clinical findings of these 12 patients were reviewed.


RESULTS
The most common clinical presentation was fever (100%). Typical features of gastroenteritis were present in only over half of the patients. Liver function tests were abnormal in all patients. The most common abdominal manifestations on CT were the presence of mesenteric lymphadenopathy and splenomegaly (75%). Other features were circumferential small bowel wall thickening (58.3%) and free intraperitoneal fluid (50%). Three patients were found to have complications; one with bleeding from terminal ileal ulceration, another with an ileal perforation and the third with renal abscess formation.


CONCLUSIONS
CT is useful in evaluating enteric fever in patients with severe forms of presentation, a longer clinical course or less specific symptoms. Although the imaging features overlap with other abdominal infections, when combined with clinical features, travel history to endemic areas and presence of transaminitis, the diagnosis of enteric fever should be considered. CT in particular, is useful for the detection of complications such as perforation, bleeding and abscess formation.
Department of Diagnostic Imaging, National University Hospital, National University Health System, Singapore.
Tiffany
T
Hennedige
Doris S
DS
Bindl
Ambika
A
Bhasin
Sudhakar K
SK
Venkatesh
D000038:Abscess / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001202:Ascitic Fluid / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010284:Paratyphoid Fever / Q000000981:diagnostic imaging*; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D012482:Salmonella paratyphi A; D012484:Salmonella paratyphi B; D012485:Salmonella typhi; D013163:Splenomegaly / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014435:Typhoid Fever / Q000000981:diagnostic imaging*