title: Arthritis and adult respiratory distress syndrome: unusual presentations of typhoid fever.
abstract: A middle-aged woman presented with fever of 1-month duration along with bilateral knee joint pain, swelling and difficulty in walking for 2 weeks. The patient's Typhidot test was positive for IgM antibodies. Her Widal test was negative, and blood culture and synovial fluid culture were sterile. She was started on ceftriaxone, to which her fever initially responded. However, after 4 days of treatment her disease course was complicated by relapse of fever and acute respiratory distress syndrome (ARDS). This settled with respiratory support and addition of azithromycin. Following recovery from ARDS and fever, her persistent knee arthritis responded to intra-articular methyl prednisolone instillation.
authors.affiliation: Department of Rheumatology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Urmila
authors.initials: U
authors.lastname: Dhakad
authors.affiliation: Department of Rheumatology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Siddharth K
authors.initials: SK
authors.lastname: Das
authors.affiliation: Department of Rheumatology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Durgesh
authors.initials: D
authors.lastname: Srivastva
authors.affiliation: Department of Rheumatology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Nolkha
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy / Q000209:etiology*; D017963:Azithromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007719:Knee Joint; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D014435:Typhoid Fever / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D017963:Azithromycin; D011239:Prednisolone