Hepatic dysfunction in paediatric typhoidal salmonellosis

Although hepatic dysfunction has been described among adults with typhoid, there are few reports of significant hepatic functional impairment in children with typhoid. Of 435 children with culture-proven typhoid seen at the Aga Khan University Hospital, hepatomegaly was noted in 125 (29%) and isolated right hypochondrial tenderness in three (7%). Liver function tests performed on 156 of these children were normal in 121 (78%) and showed significant hepatic dysfunction in 35 (22%). Patients with significant hepatic dysfunction were more toxic (p < 0.001) at presentation and had higher mortality (p < 0.002) than those with normal liver function. Two children presented with a picture of fulminant hepatic failure with fatal outcome.