SHM Converge Scientific Abstract ePoster Gallery-Typhoid Fever and Covid-19: Masquerading Diagnoses in the Era of Masks

Pdf Summary

This case describes a 21-year-old man hospitalized in October 2020 with fever, cough, congestion, abdominal pain, and elevated inflammatory markers, liver enzymes, and low platelets. Because these symptoms overlapped with COVID-19, he was initially evaluated for SARS-CoV-2 and other infections and treated empirically with ceftriaxone and azithromycin. Repeat COVID testing remained negative, but blood cultures later grew <em>Salmonella</em>, ultimately identified as <em>Salmonella Typhi</em>. He improved after treatment was changed to cefpodoxime.

The report emphasizes how typhoid fever can mimic COVID-19. Both illnesses may present with fever, cough, thrombocytopenia, elevated transaminases, and abnormal chest imaging. In this patient, bibasilar lung opacities and a small pleural effusion further complicated the picture.

Key clues favoring typhoid fever included hepatosplenomegaly, diffuse intra-abdominal lymphadenopathy, and a history of vomiting and diarrhea beginning days after eating at a food truck three weeks earlier. This timing fit the incubation period of typhoid fever, where symptoms often develop 3 to 21 days after exposure. These abdominal findings are less typical of COVID-19.

The case highlights the importance of maintaining a broad differential diagnosis during the COVID era, especially when symptoms overlap with common viral syndromes. Careful attention to exposure history, symptom timing, and atypical imaging findings can help distinguish typhoid fever from COVID-19 and prevent delayed diagnosis.

Asset Subtitle

Asim Viqar

Meta Tag

Author List Alexandra R. Linn, Asim Viqar, Brooke Bernardin, Pranav Shah, Thomas C. Daubert

Category Clinical Vignettes

Concept Salmonella typhi infection

Concept COVID-19

Concept Fever

Concept Clinical Presentation

Concept Laboratory Findings

Distinguished Non-Finalist

Presenter Organization University of Pennsylvania

Presenting Author Asim Viqar

Track Adult

Keywords

typhoid fever

Salmonella Typhi

COVID-19 mimic

fever

thrombocytopenia

elevated transaminases

hepatosplenomegaly

intra-abdominal lymphadenopathy

blood culture

food truck exposure

Salmonella typhi infection

COVID-19

Fever

Clinical Presentation

Laboratory Findings