Table 2.
Clinical characteristics of the three children positive for HAV IgM and concurrent S.Typhi/S. Poona
| Characteristic | Child 1: hepatitis A with S. Typhi | Child 2: hepatitis A with S. Typhi | Child 3: hepatitis A with S. Poona |
|---|---|---|---|
| Age (completed years) | 10 | 10 | 12 |
| Gender | Male | Male | Male |
| First presenting symptom (duration in days) | Fever (8) | Fever (7) | Fever (5) |
| Time of presentation of jaundice during the illness episode | First week | First week | Second week |
| Other symptoms | Abdominal pain, loss of appetite, and vomiting | Abdominal pain, loss of appetite, and vomiting | Abdominal pain and loss of appetite |
| Hospitalization | Yes | No | No |
| Investigations | |||
| HAV IgM | Positive | Positive | Positive |
| Blood culture | S. Typhi | S. Typhi | S. Poona |
| Liver function test | |||
| Total bilirubin (TB) (mg/dL) | 6.2 | NA | 5.8 |
| Direct bilirubin (DB) (mg/dL) | 5.7 | 3.7 | |
| AST (U/L) | 127 | NA | 371 |
| ALT (U/L) | 578 | NA | 1,027 |
| ALP (U/L) | 282 | NA | 307 |
| Ultrasonogram of abdomen | Distended gallbladder with thickened and edematous outer wall | NA | NA |
| Treatment taken | IV ampicillin, gentamycin, metronidazole, cefotaxime for 2 days, followed by oral cefixime for 15 days | Oral azithromycin for 12 days | Oral azithromycin for 5 days |
| Outcome | Recovered without sequela | Recovered without sequela | Recovered without sequela |
NA = not available; S. Poona = Salmonella Poona; S. Typhi = Salmonella Typhi.