Enteric fever with enteral bleeding: A case report

Mustafa Kemal ÇELEN,Celal AYAZ,Mehmet ULUĞ,Hakan ERAYDIN,Mehmet Faruk GEYİK,Ercan GEDİK

Abstract

Rectal bleeding is a rare complication of enteric fever but it has high morbidity and mortality risk. A 22 years old male patient which was came with; fever, headache, dry cough and appetite, was hospitalized to our clinic. He ate raw meatball and lettuce two weeks before in his history, was learned. His laboratory findings were; WBC: 4900/mm3 (lymphocyte 40%), heamatocrit 39,6 , PLT 56.900/ mm3, ESR: 23 mm/h and CRP:15. Salmonella typhi was considered at him therefore ciprofloxacine 1 gr/day was administrated. S. typhi was grown from his blood culture. His heamatocrit value decreased to 23.9 and massive rectal bleeding began therefore he was transferred to the Intensive Care Unit of Surgery. His heamatocrit value decreased to 19.4 because of this reason he was operated urgently. His therapy was completed to 21 days than he was discharged. Second operation was planed for enterostomy.

Özet

Tifoda rektal kanama nadir fakat morbidite ve mortalitesi yüksek bir komplikasyondur. Hikayesinden iki hafta önce arkadaş toplantısında çiğköfte ve marul yiyen 22 yaşındaki erkek hasta; Ateş, baş ağrısı, kuru öksürük ve iştahsızlık şikayeti ile yatırıldı. Yattığı sırada hematokriti (Htc) % 39,6 olan hastada Salmonella typhi enfeksiyonu düşünülerek siprofloksasin 500 mg. tablet 2x1 başlandı. Kan kültüründe S. typhi üredi. Masif rektal kanama gelişen hastanın Htc değeri % 23,9'a düşünce hastaya üç ünite kan verildi. Kanaması durmayan hasta genel cerrahi yoğun bakımına (GCYB) transfer edildi. Hastanın hematokrit değeri % 19,4'e düşünce acil olarak operasyona alındı. Hastanın tedavisi 21 güne tamamlanarak taburcu edildi. Enterostomi için ikinci operasyon planlandı.