A successful management of complicated ileocaecal typhoid infection: a case report

Abstract

Background: Typhoid fever is one of the serious infectious diseases caused by Salmonella Typhi. It affects both children and adults. Ileal perforation is one of the common complication of typhoid infection and it is associated with increased morbidity and mortality. The aim of this report is to present a successful management of a 6-year-old girl with multiple ileocecal typhoid lesions.

Case Presentation: A 6-year-old girl, with 3-weeks history of fever, headache, and abdominal pain with distension presented to the department of surgery of General Amadi Rimi Specialist Hospital (GARSH). On Examination she was found to be acutely ill, dehydrated and in some respiratory distress, pale and febrile (temperature of 37.9 0C). Abdominal examination revealed generalized abdominal tenderness,rigidity and guarding but bowel sounds were normal. An assessment of acute abdomen secondary to likely bowel perforation from typhoid infection was made. An exploratory laparotomy was carried in the surgical theatre after routine and other necessary investigations after obtaining signed informed consent to operate from the parents. An inflammatory mass lesion was found in the ileocecal region extending to the caecum with three perforations within it. Limited Right hemicolectomy was done. Patient made remarkable recovery and was discharged on the 13th day after the surgery.

Conclusion: The case presented has emphasized the need for the development of good clinical skills that are essential in arriving at the likely diagnosis, and helpful in giving the right treatment efficiently, especially in limited medical resources centre.

Keywords: typhoid, infection, ileocecal, antibiotics, surgery.