Salmonella liver abscess: an unusual complication of typhoid fever with hepatitis: a coinfection


  • Tonyot Gailson Department Paediatrics, Government Multi Speciality Hospital, Chandigarh, Punjab, India
  • Sadbhavna Pandit Department Paediatrics, Government Multi Speciality Hospital, Chandigarh, Punjab, India



Co-infection, Liver abscess, Poor sanitation, Salmonella typhi, Typhoid fever, Viral hepatitis


Typhoid fever continues to be a major cause of mortality and morbidity particularly in children and adolescent in developing countries due to poor sanitation and lack of safe drinking water facilities.

Even in antibiotic era, complications of typhoid fever continue to be a common problem due to many factors like inadequate treatment, delayed presentation, drug resistance and associated morbidity. Hepatic involvement in typhoid fever is common in children, but liver abscess due to Salmonella species is rare. We hereby present a case of a 5-year-old Indian female child who was initially managed as acute viral hepatitis (hepatitis-A IgM positive). However, persistence of fever and pain abdomen led to the diagnosis of liver abscess on ultrasound. Blood culture and aspirate of the abscess grew salmonella typhi. She was adequately managed with intravenous antibiotics leading to complete resolution of the abscess.


Crump JA, Mintz ED. Global trends in typhoid and paratyphoid fever. Clin Infect Dis Off Publ Infect Dis Soc Am. 2010;50(2):241-6.

Mogasale V, Maskery B, Ochiai RL, Lee JS, Mogasale VV, Ramani E, et al. Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment. Lancet Glob Health. 2014;2(10):e570-80.

Ochiai RL, Acosta CJ, Danovaro-Holliday MC, Baiqing D, Bhattacharya SK, Agtini MD, et al. A study of typhoid fever in five Asian countries: disease burden and implications for controls. Bull World Health Organ. 2008;86(4):260-8.

Huang DB, Herbert L Du Pont. Problem pathogens: extra-intestinal complications of Salmonella enterica serotype Typhi infection. Lancet Infect Dis. 2005;5(6):341-8.

WHO, 2003. Background Document: The Diagnosis, Treatment and Prevention of Typhoid Fever. Geneva: WHO/V&B/03.07. Available at: Accessed on 9 June 2019.

Kliegman R, Behrman RE, Nelson WE. Nelson Textbook of P. Ediatrics. In: Kliegman R, Behrman RE, Nelson WE, editors. The nervous system, vol. 2. 20th Ed. Phialdelphia: Elsevier; 2016:1390.

Britto C, Pollard AJ, Voysey M, Blohmke CJ. An Appraisal of the Clinical Features of Pediatric Enteric Fever: Systematic Review and Meta-analysis of the Age-Stratified Disease Occurrence. Clin Infect Dis Off Publ Infect Dis Soc Am. 2017;64(11):1604-11.

Luxemburger C, Dutta AK. Overlapping Epidemiologies of Hepatitis A and Typhoid Fever: the Needs of the Traveler. J Travel Med. 2005;12(Suppl. 1):S12-21.

Ronovito V, Bonanno CA. Salmonella hepatic abscess: An unusual complication of Salmonella carrier state? Am J Gastroenterol. 1982;77(5):338-9.

Jagadish K, Patwari AK, Sarin SK, Prakash C, Srivastava DK, Anand VK. Hepatic manifestations in typhoid fever. Indian Pediatr. 1994;31(7):807-11.

Mishra D, Chaturvedi D, Mantan M. Typhoid fever and viral hepatitis. Indian J Pediatr. 2008;75(5):509-10.