Olubodun J O, Kuti J A, Adefuye B O, Talabi A O
Department of Medicine, Ogun State University Teaching Hospital, Shagamu, Nigeria.
Cent Afr J Med. 1994 Sep;40(9):262-4.
While typhoid is quite common in our environment, presentation in association with severe hepatitis and hepatic encephalopathy is uncommon. The case of a 14 year old male with typhoid who presented with jaundice and severe hepatitis with encephalopathy is presented. The first symptoms occurred one week before presentation. The clinical features and laboratory investigations confirmed typhoid fever. The associated severe hepatitis could have been related to a direct liver involvement by Salmonella typhi, drug toxicity or hepatitis B infection from previous indiscriminate parenteral drugs. The specific cause of the hepatitis could not be confirmed. The patient is presented to illustrate a rare association and possible complication of typhoid fever, inappropriate self and other medication in the place of proper hospital presentation and assessment and the diagnostic difficulties confronting many centres in the developing environment.
虽然伤寒在我们所处的环境中相当常见，但合并严重肝炎和肝性脑病的情况并不常见。本文介绍了一名14岁患伤寒的男性病例，该患者出现黄疸、严重肝炎并伴有脑病。首发症状出现在就诊前一周。临床特征和实验室检查确诊为伤寒热。相关的严重肝炎可能与伤寒杆菌直接侵犯肝脏、药物毒性或既往滥用非肠道用药导致的乙型肝炎感染有关。肝炎的确切病因无法确定。介绍该病例是为了说明伤寒热一种罕见的关联及可能的并发症、在应前往医院进行恰当诊治时自行用药及使用其他不当药物的情况，以及发展中环境下许多医疗中心面临的诊断困难。
