What are the neuropsychiatric complications of typhoid fever (enteric fever)?

Updated: Aug 19, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

In the past 2 decades, reports from disease-endemic areas have documented a wide spectrum of neuropsychiatric manifestations of typhoid fever. Potential neuropsychiatric manifestations of typhoid fever include the following:

  • A toxic confusional state, characterized by disorientation, delirium, and restlessness, is characteristic of late-stage typhoid fever. In some cases, these and other neuropsychiatric features dominate the clinical picture at an early stage.

  • Facial twitching or convulsions may be the presenting feature. Meningismus is not uncommon, but frank meningitis is rare. Encephalomyelitis may develop, and the underlying pathology may be that of demyelinating leukoencephalopathy. In rare cases, transverse myelitis, polyneuropathy, or cranial mononeuropathy develops.

  • Stupor, obtundation, or coma indicates severe disease.

  • Focal intracranial infections are uncommon, but multiple brain abscesses have been reported. [77]

  • Other less-common neuropsychiatric manifestations events have included spastic paraplegia, peripheral or cranial neuritis, Guillain-Barré syndrome, schizophrenialike illness, mania, and depression.


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