Coinfection with invasive salmonella and leptospira presenting as cholestatic typhus hepatitis in a child from a high Andean area

Abstract

Typhoid fever is endemic in our environment and leptospirosis is an emerging zoonosis in the last 5 years. Recent reports show co-infection of salmonella and leptospira, with complications such as intestinal obstruction, splenic abscess, vertebral osteomyelitis, among others, observed during its evolution. Objective: to report the case of an 8-year-old boy from Ayacucho who presented with invasive salmonella and leptospira presenting as cholestatic typhus hepatitis. Clinical case: schoolboy who presented persistent fever associated with abdominal pain, hepatosplenomegaly and cholestatic jaundice with positive blood culture for salmonella thypi and positive ELISA Ig M serology for leptospira. During the evolution of the Co-infection, he presented acute hepatitis with a cholestatic pattern and delay in clinical recovery and normalization of liver tests. Conclusion: despite the high prevalence of typhoid fever in our environment and the growing increase in leptospira cases, we suggest the search for salmonella and leptospira infection in patients with persistent fever associated with gastrointestinal symptoms, even more so if they have a history of epidemiological importance in order to avoid serious complications during evolution.