Pediatric Infectious Disease

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VOLUME 5 , ISSUE 3 ( July-September, 2023 ) > List of Articles


Necrotic Lymphadenopathy in a 12-year-old Boy with Enteric Fever: An Uncommon Presentation

Ravi Chirag, Bharath Jayachandra, Thirunavukkarasu Arun Babu

Keywords : Case report, Enteric fever, Lymphadenopathy, Necrotic, Pediatric, Salmonella

Citation Information : Chirag R, Jayachandra B, Arun Babu T. Necrotic Lymphadenopathy in a 12-year-old Boy with Enteric Fever: An Uncommon Presentation. Pediatr Inf Dis 2023; 5 (3):100-101.

DOI: 10.5005/jp-journals-10081-1400

License: CC BY-NC 4.0

Published Online: 29-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


This case report describes a 12-year-old boy who presented with high-grade fever, joint pain, abdominal pain, and general weakness. The Widal test showed positive results with ‘O’ and ‘H’ antibody titers of 1:320. Additionally, the blood culture report confirmed the growth of Salmonella typhi, leading to the diagnosis of enteric fever. An abdominal ultrasound (USG) was performed due to severe abdominal pain, revealing the presence of multiple discrete necrotic lymph nodes in the right subhepatic and right iliac fossa, with the largest node measuring 1.6 cm. The child was treated with ceftriaxone (1 gm twice daily) and azithromycin (20 mg/kg), resulting in a gradual improvement of symptoms. To the best of our knowledge, this is the first reported case of necrotic lymphadenopathy in enteric fever confirmed by abdominal imaging in the pediatric population.

  1. Kumar S, Rizvi M, Berry N. Rising prevalence of enteric fever due to multidrug-resistant Salmonella: an epidemiological study. J Med Microbiol 2008;57(10):1247–1250. DOI: 10.1099/jmm.0.2008/001719-0
  2. Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases E-book. Elsevier Health Sci; 2019.
  3. Arun Babu T, Ananthakrishnan S, Jayakumar P, et al. Unusual complication of toxic megacolon in typhoid colitis. Indian J Pediatr 2014;81(5):504–506. DOI: 10.1007/s12098-013-1115-7
  4. Nair IR, Balan S, Phalak P, et al. Clinicopathologic spectrum of necrotizing lymphadenitis. Indian J Pathol Microbiol 2020;63(1):60–63. DOI: 10.4103/IJPM.IJPM_622_19
  5. Cho KJ, Kim CW, Park SH, et al. Necrotizing lymphadenitis–a clinico-pathologic study of 36 cases with immunohistochemical analysis.J Korean Med Sci 1991;6(1):55–61. DOI: 10.3346/jkms.1991.6.1.55
  6. Kumar M. Surgical management and post-operative complications in abdominal tuberculosis patients. Int Surg J 2020;7(4):1106. DOI: 10.18203/2349-2902.isj20201168
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