A 25-year-old girl had splenomegaly, leucopenia, fever, and died in a few days. Longitudinal ulcers were found in intestine. What should be the probable diagnosis
Splenomegaly, leucopenia, fever, and longitudinal ulcers in intestine are characteristic features of enteric fever. The term enteric fever includes typhoid fever caused by Salmonella typhi and paratyphoid fever caused by Salmonella paratyphi A, B and C. As bile is a good culture medium for bacilli, they multiply abundantly in the gallbladder and are discharged continuously into the intestine, where it causes inflammation and necrosis leaving behind the characteristic typhoid ulcers. Ulceration of the bowel leads to two major complications: intestinal perforation and hemorrhage. The typical features are step ladder pyrexia with relative bradycardia and toxemia. A soft palpable spleen is a constant finding. Hepatosplenomegaly is also common. Rose spots that fade on pressure appear on the skin during the second or third week. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
Tuberculosis
Hemorrhagic fever
Amoebiasis
Enteric fever
Bacteriology