An unusual case of typhoid fever encephalitis

Abstract

Case presentation. A 13-year-old female patient with no known comorbidities consulted with a ten-day history of fever with chills, diarrhea four times a day and vomiting, treated with acetaminophen. Four days before consulting, the patient experienced adynamia, confusion and difficulty walking. She was taken by her mother to a health facility. Treatment. She was admitted to a second level hospital for suspected salmonellosis, encephalitis, water and electrolyte imbalance, acute renal injury and acute gastroenteritis with severe dehydration. She was treated with parenteral hydration and antibiotics, and was referred to a tertiary hospital for respiratory distress with need for mechanical ventilation, where a positive blood culture for Salmonella typhi was obtained. Outcome. The patient presented systemic inflammatory response syndrome due to sepsis that was managed with vasoactive amines; on the sixteenth day of hospitalization the patient presented tachycardia and fever, a blood culture positive for multidrug-resistant Acinetobacter baumannii was obtained. She presented myocarditis, neurological deterioration with a Glasgow score of 8, developed multisystemic failure and died after 32 days of hospital stay