"Coma vigil a rare neuropsychiatric complication of a pan sensitive Salmonella infection"

A 25 year old previously healthy male presented with low grade intermittent fever for ten days and confusion for two days. On examination he was febrile and confused, making abnormal unpurposeful gestures with his hands. He was not aggressive. There was no nuchal rigidity or cervical lymphadenopathy. He was started on empirical intravenous antibiotics and steroids to cover meningo encephalitis. He had a marginally elevated CRP, a normal full blood count and an unremarkable CSF analysis. The patient was started on chloramphenicol to cover typhus encephalitis. The CSF culture was sterile. Salmonella enterica serovar Typhi was isolated from blood culture.