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  • Title: Reversible encephalopathy secondary to paratyphoid infection and concomitant acute Hepatitis A.
    Author: El-Khoury M, Naoushi H, Sawaya R, Aoun E, Nassar NT, Sharara AI.
    Journal: South Med J; 2005 Jul; 98(7):723-5. PubMed ID: 16108242.
    Abstract:
    Reversible encephalopathy has been described in association with typhoid fever as well as nontyphoidal salmonella infections. A diagnostic dilemma as to the cause of encephalopathy may arise when there is coexistent acute viral hepatitis and suspicion of fulminant liver failure. The authors report a patient who presented with acute icteric hepatitis A infection and a concomitant febrile illness due to Salmonella paratyphi associated with progressive encephalopathy and coma. The young man developed high-grade fever and coma. Concomitant infection with S. paratyphi was diagnosed and the patient's encephalopathy resolved rapidly with antibiotic therapy. This is the first report of a putative association of S. paratyphi infection and reversible encephalopathy. Salmonella and hepatitis A virus infection are both transmitted via the fecal-oral route, and awareness of this association is important in the management of such patients.
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