Acute Pancreatitis as A Complication of Typhoid Fever: A Case Report

 Typhoid fever could have a wide range of complications. Pancreatitis is a rare complication in children with typhoid fever. The aim of this case report is to describe a case of typhoid fever presented with acute pancreatitis (AP).

CASE REPORT: 

A 13-year-old girl with fever and abdominal pain around the umbilical region lasting one week was referred to the Amirkola Children’s Hospital. She had recurrent non-bloody, non-biliary vomiting and watery diarrhea while she had dysentery during admission. She had drunk spring water in a recent trip. The stool culture was positive for Salmonella Typhi. The Widal test results were first: TO:1.80, TH:1.80 and after one week: TO:1.320, TH:1.320. Hydrotherapy along with treatment with cefotaxime (50 mg/kg for 14 days) recovered the patient from dysentery, nausea and fever. After one week, she complained of periumbilical abdominal pain, vomiting and tenderness of epigastric region. Lipase level was elevated to 500 U/L and her pain became worse. Spiral abdominopelvic CT scan showed normal liver, spleen, gallbladder and bile ducts. However, the pancreas tail was hypodense and larger than normal. The pancreatitis was treated by hydration and intravenous pantoprazole. After two weeks of admission, she was discharged with remission, and the lab tests and ultrasound examination were normal within a 4-week follow-up.

 According to this case report the pancreatitis should be considered in children with typhoid fever and persistent abdominal pain.