Afsar Nikhat Shahla, Marisa Sumaiya Farah, Mohona Sayat Quayum, Ashraf Sohely, Rahman Mahfuzur, Sami Chowdhury Adnan
Department of Internal Medicine, Evercare Hospital Dhaka, Bangladesh.
IDCases. 2025 Mar 24;40:e02203. doi: 10.1016/j.idcr.2025.e02203. eCollection 2025.
Typhoid fever, leading to systemic disease due to Salmonella enterica serotype Typhi, typically has gastrointestinal manifestation, however, neurologic complications-although uncommon, can arise. Aseptic meningitis and optic neuritis are rare manifestations that can be challenging to diagnose.
Our patient a 31-year male presented with fever for 18 days associated with headache, rash, vomiting, diarrhea and progressive neurological symptoms in form of disorientation and blurred vision. On examination there was bilateral sixth cranial nerve palsy. Investigations were positive for typhoid fever with aseptic meningitis and optic neuritis. He was successfully treated with intravenous ceftriaxone and corticosteroids.
Atypical neurological symptoms of typhoid fever must be recognized. To prevent complications, early diagnosis and treatment are important. Typhoid fever should be considered in febrile patients with unexplainable neurological symptoms, especially in an endemic region.
伤寒热由伤寒沙门氏菌引起,可导致全身性疾病,通常有胃肠道表现,然而,神经系统并发症虽然不常见,但也可能出现。无菌性脑膜炎和视神经炎是罕见的表现,诊断可能具有挑战性。
我们的患者是一名31岁男性,发热18天,伴有头痛、皮疹、呕吐、腹泻以及以定向障碍和视力模糊形式出现的进行性神经症状。检查发现双侧第六颅神经麻痹。检查结果显示伤寒热合并无菌性脑膜炎和视神经炎呈阳性。他通过静脉注射头孢曲松和皮质类固醇成功治愈。
必须认识到伤寒热的非典型神经症状。为预防并发症,早期诊断和治疗很重要。对于有无法解释的神经症状的发热患者,尤其是在流行地区,应考虑伤寒热。