Neuropsychiatric signs and symptoms are relatively common in patients with typhoid fever (up to 40% of patients). Usually the findings are reversible if the patient survives but residua may persist.

Neurologic findings:

(1) transverse myelitis (bilateral pyramidal tract signs with spasticity, hyperreflexia, ankle clonus and Babinski sign, bowel and bladder dysfunction)

(2) cerebellitis (ataxia, intention tremor, dysarthria, nystagmus, etc)

(3) meningoencephalitis or encephalitis

(4) polyneuropathy

(5) Parkinson's disease

(6) polymyositis

(7) meningitis


Psychiatric findings:

(1) acute confusional state

(2) acute psychosis or schizophrenia


A small percent of patients may develop bizarre neuropsychiatric syndromes that are difficult to classify.


The new-onset of a neuropsychiatric finding in a febrile patient may be an early indication of typhoid fever.

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