Into the Enteric Verse Fighting Metabolic Acidosis

Enteric fever is an acute infectious disease caused by Salmonella Typhimurium and Salmonella Paratyphimurium. There is a high incidence of 100-1600 cases per 100000 cases annually in South-Asian countries like Nepal. A few cases of complications of enteric fever such as metabolic acidosis, sepsis and Acute Respiratory Distress Syndrome (ARDS) have been reported. Here, we report a case of 18-year-old male with typical features of blood and stool culture positive enteric fever who developed sepsis and metabolic acidosis while being treated with oral antibiotics during his course of illness. Examination showed raised temperature, low blood pressure, diffuse crepitation on chest auscultation and collapsed inferior venacava (IVC) on bed side ultrasonography (USG). Patient was then treated in Intensive Care Unit (ICU) with intravenous antibiotics and other supportive treatment for total of seven days. At the time of discharge, patient was afebrile and there was no growth on blood and stool culture.