Typhoid fever is a febrile illness with a variety of systemic manifestations; however, icteric typhoid hepatitis, mimicking the clinical features of acute hepatitis, is very uncommon.
A 45-year-old man was admitted to the hospital for evaluation of fever, dark-colored urine, and jaundice. On admission, the total bilirubin was 4.3 mg/dL, and the AST and ALT were 468 and 319 IU/L, respectively. Salmonella typhi was identified by blood culture. A liver biopsy revealed some mononuclear cell infiltrations without hepatocyte necrosis or typhoid nodules. CT scan findings showed splenomegaly and mesenteric lymphadenopathy.
With the administration of ceftriaxone, he became afebrile and showed improvement in the jaundice, with normalization of AST and ALT.
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