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July 25, 1977

Myoglobinuria and Renal Failure Associated With Typhoid Fever

JAMA. 1977;238(4):341. doi:10.1001/jama.1977.03280040061026

ACUTE renal failure due to myoglobinuria has been described with numerous disorders, including trauma, ischemic diseases, drugs and toxins, systemic infections, McArdle's disease, and alcoholism.1,2 To our knowledge, typhoid fever has not yet been reported with myoglobinuria and acute renal failure.

Report of a Case  Six days before admission our 32-year-old patient began to have chills, fever, headaches, crampy abdominal pain, and 15 to 20 watery brown stools daily. He was treated with aspirin, a mixture of magnesium hydroxide and aluminum hydroxide gel (Maalox), a mixture of belladonna alkaloids and phenobarbital (Donnatal), and penicillin without relief. He noted a gradual onset of dark urine and yellow discoloration of his eyes. There was no dysuria, melena, hematemesis or hematochezia, upper respiratory tract infection, myalgia arthralgia, weakness, or rash, and no history of drug or ethanol abuse, transfusions, recent travel outside the United States, exposure to hepatitis, toxins, or rat-infested or