Perforation of terminal ileum and appendix in typhoid enteritis: report of two cases.

Two cases of simultaneous typhoid perforation of terminal ileum and appendix are reported from Harare Central Hospital. These findings have not been reported before. Perforations were associated with schistosomiasis and HIV/AIDS. Definitive diagnosis was made only after laparotomy, serology and histopathology. With early diagnosis, effective resuscitation and timely intervention, this life-threatening condition is not necessarily fatal. Septic shock is however, an ominous sign of poor prognosis. In the tropics, bradycardia, leukopaenia and perforation in a febrile patient with right iliac fossa tenderness should arouse suspicion. Perforations may occur in patients with underlying diseases.