SHM Converge Scientific Abstract ePoster Gallery-Uncommon Complications of Salmonella Typhi: A Case Report of Concurrent Hemolysis and Hepatitis

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This case report describes a 30-year-old man with eosinophilic esophagitis who developed fevers, fatigue, poor appetite, and diarrhea after traveling to India. On exam, he had a temperature of 102.4°F, a heart rate of 80 bpm, and palpable hepatosplenomegaly. CT imaging showed diffuse enterocolitis, hepatosplenomegaly, and mesenteric lymphadenopathy. Laboratory testing revealed pancytopenia, low haptoglobin, elevated LDH, and increased creatinine, followed by transaminitis. Blood cultures and stool PCR confirmed Salmonella typhi infection.<br /><br />The report highlights uncommon complications of S. typhi, including concurrent hemolysis and hepatitis. Salmonella typhi is a rare cause of hospitalization in the United States, with about 620 cases annually. Typical features of enteric fever include diarrhea, relative bradycardia, mesenteric lymphadenopathy, and hepatosplenomegaly due to reticuloendothelial system involvement. Pancytopenia can occur from bone marrow infiltration. Hemolysis may be triggered by hemolysins, while hepatic injury may result from direct endotoxin damage and host inflammatory responses.<br /><br />The patient improved with antibiotics, supporting the importance of prompt recognition and treatment. The case emphasizes that clinicians should consider typhoid fever in returning travelers with fever and gastrointestinal symptoms, especially when there are signs of systemic involvement such as cytopenias, organomegaly, hemolysis, or liver enzyme elevation.

Asset Subtitle

Agostina E. Velo

Meta Tag

Author List Agostina E. Velo, Anahi McIntyre, Caileen Sennett, Connor Smith, Lindsey Fox

Category Clinical Vignettes

Concept Salmonella typhi infection

Concept Fever

Concept Hemolysis

Concept Hepatocellular Injury

Concept Blood Culture

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside West, Icahn School of Medicine

Presenting Author Agostina E. Velo

Track Adult

Keywords

Salmonella typhi

typhoid fever

enteric fever

travel medicine

hepatosplenomegaly

pancytopenia

hemolysis

hepatitis

diarrhea

returning traveler

Salmonella typhi infection

Fever

Hemolysis

Hepatocellular Injury

Blood Culture