Massive Gastrointestinal Hemorrhage Secondary to Typhoid Fever

Abstract

Typhoid fever is caused by Salmonella typhi, a gram-negative organism. The disease usually presents with high-grade fever, abdominal pain, and diarrhea. Gastrointestinal hemorrhage is a frequent complication of the disease. However, adequate treatment with antibiotics has lowered the rate of complications. We present the case of a 21-year-old male who was admitted to the hospital with high-grade fever and per rectal bleeding. A few hours after admission, the patient had episodes of massive per rectal bleeding which resulted in hemodynamic instability. The bleeding was then successfully controlled with endoscopic hemoclipping. Concurrently, his blood culture results showed growth of Salmonella typhi for which antibiotic therapy was initiated, and the patient's condition improved thereafter. This report highlights the rare occurrence of massive lower gastrointestinal bleeding in patients with typhoid fever. It also signifies the use of endoscopic therapy with endoclips for the management of massive lower gastrointestinal bleeding.

Keywords: colonoscopy; endoscopic clipping; gastrointestinal complications; massive gastrointestinal hemorrhage; salmonella typhi; typhoid fever.