Postpartum Typhoid Intestinal Perforation

Abstract

Background: Typhoid fever remains a highly contagious and multi-systemic infection caused by salmonellae typhi, and like other gastro-enteric infection, it poses a higher risk of morbidity and mortality during pregnancy as a result of the physiological changes associated with pregnancy as well as concerns of antibiotic safety in pregnancy. The occurrence of typhoid perforation in pregnancy may be easily confused for other causes of acute abdomen in pregnancy. We report the presentation, management and outcome of a 25 year old postpartum woman who presented with typhoid intestinal perforation in a resource limited environment. She had an emergency exploratory laparotomy and was managed post operatively in the ICU but clinically deteriorated and subsequently died on the third post-operative day secondary to multiple organ failure from severe sepsis. Typhoid perforation in pregnancy is a rare presentation, a high index of suspicion, and early intervention, would reduce the incidence of morbidity and mortality associated with this disease condition.