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Journal of Tropical Pediatrics 1999 45(5):287-290; doi:10.1093/tropej/45.5.287
© 1999 by Oxford University Press
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Typhoid hepatitis in children

AK ShettyA,Z, SR MitalB, AHT BahrainwalaB, RP KhubchandaniB and NB KumtaB

A Department of Pediatrics, Louisiana State University Medical Centre, New Orleans, LA, USA B Kasturba Hospital for Infectious Diseases, Bombay, India Z Corresponding author address: Paediatric Infectious Diseases, Room G312, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, CA 94305-5208, USA

Liver involvement is commonly observed in patients with typhoid fever. However, a hepatitis-like picture with fever and jaundice is unusual and infrequently reported in the paediatric literature. Our aim was to characterize the clinical picture, biochemical features, and prognosis of typhoid hepatitis. One hundred cases of typhoid fever (age 0 to 12 years), proven by positive blood cultures to Salmonella typhi, were found to have hepatitis during the course of their illness. All had high fever, tender hepatomegaly, elevated serum bilirubin (in the range of 2.5-5.8 mg/dl), and elevated serum alanine transaminase levels (in the range 100-620 IU/I). All the eight patients showed complete clinical and biochemical recovery in response to appropriate antibiotics. The clinical picture of typhoid hepatitis frequently mimics acute viral hepatitis. In tropical areas, the differential diagnosis of a child presenting with fever and jaundice should include typhoid hepatitis.


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