Neuro-psychiatric manifestations of typhoid.

The clinical pattern of typhoid fever is changing, and in particular the incidence of neuro-psychiartic manifestations is on the increase. In 246 cases of enteric fever we found 124 with confusional states, delirium, coma, generalized myoclonus, Parkinsonian rigidity or psychoses. We further distinguished two major sub-groups with an acute and an insidious onset. The apparent increase in the frequency of neuro-psychiatric complications of typhoid could represent a change in the pathogenicity of S. typhi or the increasing recognition of a biochemical defect caused by a bacterial endotoxins and provoked by poor nutrition.