Typhoid Encephalopathy: When Fever Takes Over The Mind – A Compelling Case Study and Insightful Review

Abstract Typhoid fever, caused by Salmonella enterica serotype Typhi, remains a significant health concern in many developing countries. While the disease predominantly affects the gastrointestinal tract, it can also involve multiple organ systems, including the central nervous system, leading to a rare but serious complication known as typhoid encephalopathy. This neuropsychiatric manifestation is characterized by altered mental status, ranging from confusion and delirium to deep coma. The pathophysiology of typhoid encephalopathy is not entirely understood, but it is believed to be associated with the systemic inflammatory response and cytokine release rather than direct bacterial invasion of the brain. The diagnosis is primarily clinical, supported by the presence of typhoid fever, and the exclusion of other causes of encephalopathy. Management includes prompt antibiotic therapy, supportive care, and the management of complications. This case report discusses a patient with typhoid encephalopathy, detailing the clinical presentation, diagnostic workup, treatment, and outcomes. Through this case, we aim to highlight the importance of early recognition and treatment of this rare complication to prevent adverse outcomes. Additionally, we review the current literature on the pathophysiology, clinical features, differential diagnosis, and management strategies for typhoid encephalopathy. Despite advances in public health measures and vaccination, typhoid fever and its complications remain prevalent in endemic areas. This underscores the need for ongoing efforts to improve diagnosis, treatment, and prevention strategies.