A Case of Typhoid Fever Complicated with Meningitis, Cervical Spondylitis and Epidural Abscess / 감염과화학요법

ABSTRACT

Typhoid fever still steadily occurrs, although its incidence decreased in Korea. Even though the clinical manifestations of typhoid fever are varied, there has been no reported case complicated with meningitis, cervical spondylitis and epidural abscess simultaneously. We experienced a case of typhoid fever in an immunocompetent patient complicated with meningitis, cervical spondylitis and cervical epidural abscess. A 55-year old woman was admitted because of fever and neck pain. The finding of her lumbar puncture was compatable with bacterial meningitis, and Salmonella enterica Typhi was found in blood cultures. Despite of medical treatment, neck pain, radiating to upper extremities, was aggravated. Cervical MRI revealed an anterior epidural abscess with spondylitis and discitis at the level of the 5th and 6th cervical vertebral bodies. Removal of epidural abscess and laminectomy were performed for cervical spinal cord compression. Ciprofloxacin was intravenously given for up to one month and was then switched to oral formula. She was cured without neurologic sequelae and has had no relapse for 1 year follow-up.