Enteric fever with hepatitis and ASD

A 7 year old child from Sandvip, an Island west of Chittagong came to our hospital with fever for 22 days, jaundice and abdominal pain.

On examination, his jaundice was moderate, abdomen was tender on the epigastric, right lumber and Rt hypochondriac region. His liver was 5 cm enlarged, tender.

Ausculatation of the heart reveals a murmur which is systolic in nature at the left upper sternal border.

We thought it could be a) a case of Infective Endocarditis out of a noncyanotic congenital heart disease
b) Enteric fever with hepatitis
c) Hepatic abcess


We started treating the patient with Injection Ceftrixone and Inj penecillin.

In the meantime , the investigation reveals normal widal test, normal blood culture and X-ray shows mild cardiomegaly and Echocardiography suggests ASD.

The fever started to subside and sense of wellbeing improved on the 4th day and by 9th day, the patient become afebrile.

After review, we settled our final diagnosis as Enetric Fever with hepatitis and ASD.