Last update:
01-Apr-2009

A case is reported of coinfection with two infections rare in Greece, typhoid fever and hepatitis E. A 32 year-old man was admitted with high temperature, chills, diarrhoea and jaundice. He had arrived in Greece one week earlier, coming from his home country, Bangladesh. On clinical examination the patient had BP 90/60 mmHg, pulse 68/min and temperature 40 oC. Laboratory investigation showed disturbance of hepatic function with high values of transaminases and bilirubin. Markers for acute A, B and C hepatitis were negative, but IgM antibodies for hepatitis Ε were positive. Because of the high temperature and chills, a blood test for malaria was performed, which was negative and blood and urine cultures were taken, from both of which Salmonella typhi was isolated. Treatment with ciprofloxacin 400 mg/bd was commenced, but the general condition of the patient did not improve. Drug sensitivity testing showed susceptibility to quinolones. Fever subsided following prescription of ceftriaxone 4 g/day. The patient stayed in hospital for a month during which there was a gradual improvement in the hepatic function tests. In conclusion, although typhoid fever and hepatitis E are both rare infections in Greece, it is possible for coinfection to happen, as many foreigners from endemic regions come to this country.

Key words: Coinfection, Hepatitis E, Salmonella typhi.