A Retrospective Study of the Relationship Between Typhoid and Vestibular Disorders- A Case Series

Abstract

Background: Typhoid fever is caused by Salmonella enterica serovar Typhi (Salmonella Typhi). faecal-oral is the main route of transmission by contaminated water or food. Over the last few years, the classic presentation of typhoid fever has varied, and the cases with atypical presentation are increasing. In this study we are presenting a retrospective evaluation of patients presenting with giddiness post history of typhoid, to correlate a link between vestibular disorders and typhoid. Aims and Objectives: To retrospectively study the relationship between typhoid and vestibular disorders. Materials and Methods: This is a retrospective hospital-based case series conducted in vertigo clinic in The Department of ENT at SGT Medical College Hospital and Research Institute, Budhera, Gurugram. Five patients who gave positive history of typhoid, their case files were retrospectively evaluated. All the patients were made to undergo routine ENT, vertigo, and audiological evaluation. Results: Total of 5 patients presented to vertigo clinic at SGT hospital with complains of giddiness, all of them gave a history of typhoid in the past few weeks. Majority of patients presented with giddiness within four weeks after history of typhoid infection. Patients developed symptoms of giddiness, nausea, and vomiting. Out of 5 patients,4 were females and one male. Two patients were in the age group of 30-40 years. Two patients were in paediatric age group. On examination, Dix Hallpike test was positive in 3 patients. Patients were treated with vestibular sedatives and corrective manoeuvre like Epley’s. Pure tone audiometry, MRI brain and lab parameters were all normal in all the five patients. Conclusion: Endotoxins of the typhoid bacillus are capable of producing cochleovestibular lesions but only a few isolated reports suggest the same. Since very few literatures has been discussed on the possible correlation between vestibular disorders and typhoid, clinicians should be aware of atypical presentations of typhoid is to avoid any delay in diagnosis and prompt treatment. Therefore, there is a strong need to analyse and study the corelation between typhoid fever and vestibular disorders.