Frontiers in medicine · 2026
Spontaneous splenic rupture in a patient with paratyphoid a fever: a case report and literature review.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Yang Fangwan, Kou Zhi, Zhang Yin, Wu Xiaohuan, Zhu Yuyu, Chen Man, Li Hongmei, Zhang Shenghui, Lin Shide, Li Ying
Аннотация
BACKGROUND: Enteric fever, including both typhoid and paratyphoid fevers, is associated with a significant burden of morbidity and mortality in high-epidemic countries. However, as its incidence has declined in most countries, early diagnosis of its complications has become a clinical challenge. Spontaneous splenic rupture (SSR) is a rare but dangerous complication of typhoid fever, and its occurrence in patients with paratyphoid fever remains poorly understood. We report a case of SSR associated with paratyphoid A fever and briefly review the literature.
CASE PRESENTATION: A 15-year-old male presented with a one-week history of high fever and fatigue complicated by sudden onset of left upper quadrant abdominal pain for 2 days. Physical examination revealed diffuse abdominal tenderness without rigidity; laboratory studies showed leukocytosis and markedly elevated inflammatory markers. Blood cultures revealed Salmonella enterica serovar Paratyphi A. Contrast-enhanced computed tomography showed splenic rupture and a subcapsular hematoma, peritoneal and pelvic effusion, and peritonitis. He was hemodynamically stable, so we adopted nonoperative management. The patient recovered uneventfully. A search of English-language literature revealed only four reported SSR cases in typhoid fever and two in paratyphoid fever (one Paratyphi A and one Paratyphi B), with a mortality of 33.3% (2/6). All patients either lived in or had traveled back from high-endemic countries.
CONCLUSION: SSR is a rare but life-threatening complication of both typhoid fever and paratyphoid fever. Clinical vigilance for this complication should be maintained in patients with suspected enteric fever, even in low-endemic settings.
CASE PRESENTATION: A 15-year-old male presented with a one-week history of high fever and fatigue complicated by sudden onset of left upper quadrant abdominal pain for 2 days. Physical examination revealed diffuse abdominal tenderness without rigidity; laboratory studies showed leukocytosis and markedly elevated inflammatory markers. Blood cultures revealed Salmonella enterica serovar Paratyphi A. Contrast-enhanced computed tomography showed splenic rupture and a subcapsular hematoma, peritoneal and pelvic effusion, and peritonitis. He was hemodynamically stable, so we adopted nonoperative management. The patient recovered uneventfully. A search of English-language literature revealed only four reported SSR cases in typhoid fever and two in paratyphoid fever (one Paratyphi A and one Paratyphi B), with a mortality of 33.3% (2/6). All patients either lived in or had traveled back from high-endemic countries.
CONCLUSION: SSR is a rare but life-threatening complication of both typhoid fever and paratyphoid fever. Clinical vigilance for this complication should be maintained in patients with suspected enteric fever, even in low-endemic settings.