Hepatomegaly occurred in 27% of patients having enteric fever. Its incidence in typhoid fever (29%) was slightly higher than in paratyphoid fever (23.5%). Jaundice was noted in less than a third of the patients with hepatic enlargement. The pathological basis for the hepatic manifestations was a "nonspecific reactive hepatitis." Histological changes in the liver were also observed in patients without hepatic enlargement. Whereas hepatic manifestations appeared to be of no great clinical significance in the majority of cases, they were the dominant feature in a small but important group. These patients had the clinical features seen in other hepatic infections, like viral hepatitis and hepatic amebiasis. Hepatitis should be listed among the various presentations and complications which can occur in typhoid and paratyphoid fever.
(JAMA 230:236-240, 1974)
Ramachandran S, Godfrey JJ, Perera MVF. Typhoid Hepatitis. JAMA. 1974;230(2):236–240. doi:10.1001/jama.1974.03240020026016
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