title: Recurrent paratyphoid fever A co-infected with hepatitis A reactivated chronic hepatitis B.
abstract: We report here a case of recurrent paratyphoid fever A with hepatitis A co-infection in a patient with chronic hepatitis B. A 26-year-old male patient, who was a hepatitis B virus carrier, was co-infected with Salmonella enterica serovar Paratyphi A and hepatitis A virus. The recurrence of the paratyphoid fever may be ascribed to the coexistence of hepatitis B, a course of ceftriaxone plus levofloxacin that was too short and the insensitivity of paratyphoid fever A to levofloxacin. We find that an adequate course and dose of ceftriaxone is a better strategy for treating paratyphoid fever. Furthermore, the co-infection of paratyphoid fever with hepatitis A may stimulate cellular immunity and break immunotolerance. Thus, the administration of the anti-viral agent entecavir may greatly improve the prognosis of this patient with chronic hepatitis B, and the episodes of paratyphoid fever and hepatitis A infection prompt the use of timely antiviral therapy.
authors.forename: Yanling
authors.initials: Y
authors.lastname: Liu
authors.forename: Yujiao
authors.initials: Y
authors.lastname: Xiong
authors.forename: Wenxiang
authors.initials: W
authors.lastname: Huang
authors.affiliation: Key Laboratory of Infectious and Parasitic Diseases in Chongqing, Department of Infectious Diseases, the First Affiliated Hospital of Chongqing Medical University, No, 1 Youyi Road, Yu Zhong District Chongqing 400016, China. beijia7410@163.com.
authors.forename: Bei
authors.initials: B
authors.lastname: Jia
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D060085:Coinfection / Q000175:diagnosis* / Q000382:microbiology / Q000821:virology; D024881:Drug Resistance, Bacterial; D006506:Hepatitis A / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D030041:Hepatitis A virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use; D008297:Male; D010284:Paratyphoid Fever / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D012008:Recurrence; D012482:Salmonella paratyphi A / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D002443:Ceftriaxone