olanzapine and Typhoid-Fever

Although neurological manifestations of typhoid fever was thought to be obsolete from modern world, emergence of multidrug resistant typhoid bacilli and reporting of outbreak of typhoid fever with a range of early neuropsychiatric manifestations from various parts of world has led clinicians and investigators to re-evaluate the clinical spectrum of this endemic sinister disease. An 18-year-old male student was admitted in psychiatry ward with mutism, staring look, posturing and rigidity. There was history of typhoid fever 1 week before for which he was prescribed cefuroxime. Although investigations fail to provide any clue, his catatonic symptoms disappeared 2 weeks later giving way to resting tremor, bradykinesia, cog-wheel rigidity but without gait abnormality. He was successfully treated with lorazepam, amantidine, olanzapine and pramiprexole. The patient was asymptomatic within a month. He had no recurrence of symptoms till last follow-up, 6 months from the illness.

Topics: Adolescent; Amantadine; Antiparkinson Agents; Antipsychotic Agents; Benzodiazepines; Benzothiazoles; Catatonia; Humans; Hypnotics and Sedatives; Lorazepam; Male; Olanzapine; Parkinsonian Disorders; Pramipexole; Typhoid Fever

Many medical disorders presentwith psychiatric symptoms. Teasing out what is caused by the medical problem and what is underlying psychopathology can be a tremendous challenge. We report the case of a young man with no documented past psychiatric history that developed symptoms consistent with bipolar disorder with mood-congruent psychotic features as well as typhoid fever. In this report, we summarize the biological, psychological, and social underpinnings of this rare and interesting case.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Bipolar Disorder; Drug Therapy, Combination; Humans; Lithium Carbonate; Male; Neuropsychological Tests; Olanzapine; Paroxetine; Selective Serotonin Reuptake Inhibitors; Typhoid Fever