Role of computed tomography of abdomen in difficult to diagnose typhoid fever: a case series.

Tropical doctor

PubMedID: 29145776

Hafeez W, Rajalakshmi S, Sripriya S, Madhu Bashini M. Role of computed tomography of abdomen in difficult to diagnose typhoid fever: a case series. Trop Doct. 2017;49475517740311.
BACKGROUND AND AIM
Diagnosis of typhoid is challenging when blood cultures fail to isolate Salmonella species.We report our experience with interpreting computed tomography (CT) abdomen findings in a case series of typhoid fever.

METHODS
The case series consisted of patients who had a CT abdomen done as part of their investigations and a final diagnosis of typhoid fever.The CT films were reviewed and findings evaluated for distinctive features.

RESULTS
During 2011-2017, 11 patients met the inclusion criteria.Indication for CT was pyrexia of unknown origin in the majority of patients.

REVIEW
of CT films revealed mesenteric lymphadenopathy (100%), terminal ileum thickening (85%), hepatosplenomegaly (45%), retroperitoneal lymphadenopathy (18%) and ascites (9%).

CONCLUSIONS
Enhancing discrete mesenteric lymphadenopathy and terminal ileum thickening are non-specific findings noted in typhoid fever.Absence of matted necrotic nodes and peritoneal thickening rule out tuberculosis and raise suspicion of typhoid fever in endemic regions.