Typhoid fever presenting as multi organ dysfunction syndrome

Abstract

A 6 year old girl presented with a history of fever for 3 weeks, headache and multifocal seizures for 4 days with altered sensorium. Clinical assessment was consistent with hypotensive shock and encephalopathy. Her IgM and IgG Typhidot test was positive. Laboratory evaluation revealed deranged renal and liver functions with coagulopathy, anemia and thrombocytopenia. She did not respond to broad spectrum intravenous antibiotics, vaso-active infusions, corticosteroids and had refractory status epilepticus. She progressed rapidly to refractory septic shock and multiple organ dysfunction with AKI and ARDS. She succumbed to her illness despite antibiotics and other adjunctive therapies. This case highlights a rare and catastrophic presentation of typhoid fever.