TYPHOID FEVER COMPLICATED BY INTESTINAL PERFORATION AND MYOCARDITIS

Abstract
A 22-year-oid man ill for 3 weeks with abdominal pain, fever, diarrhea, and delirium was found to have signs of intestinal perforation after one day of therapy with chloramphenicol. Adrenal steroids were added to the program before an ilial perforation was closed at laparotomy. On the first and 2nd postoperative days, cardiac failure ensued but prompt therapy with digitalis and diuretics restored compensation. Recovery thereafter was uneventful. Steroids were discontinued on the 8th postoperative day and chloramphenicol on the 20th hospital day. Electrocardiographic abnormalities, chiefly T wave changes, persisted for 46 days but reverted to normal 10 months after hospitalization.

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