Abstract
Five cases with prolonged fever, marked toxemia, generalized lymphadenopathy, and
abdominal distension presented to us at the Institute of Child Health, Kolkata, India.
The clinical pictures mimicked enteric fever in that all of the cases had continuous
fever, toxemia, apathy, and significant abdominal distension. A clinician encountering
the cases would have thought of enteric fever except for the presence of generalized
lymphadenopathy. Investigations revealed leukocytosis, elevated acute phase reactants
(ESR and CRP), and negative blood cultures. The Weil–Felix reaction was positive in
all the cases. Our case series is an important reminder to clinicians in developing
countries that typhus fever, which is a reemerging disease, can closely mimic enteric
fever. All the children made a full recovery after treatment with oral doxycycline
or azithromycin.
Keywords
scrub typhus - enteric fever - rickettsia
