Typhoid fever presenting as histiocytic medullary reticulosis: a case report

Because of a pancytopenia, moderately cellular bone marrow with hypoplastic erythropoiesis but with active granulo- and thrombopoiesis and a conspicuous increase in histiocytic cells, a patient was provisionally diagnosed as having histiocytic medullary reticulosis. However, Salmonella typhi was cultured from blood, urine and stool specimens. After 3 weeks the Widal reaction showed a titre of 1/320 for the H-antigen and 1/1,280 for the O-antigen. The patient was treated with chloramphenicol for 10 days and the fever, enlarged spleen and enlarged lymph nodes returned to normal.