A Case of Paratyphoid with Diarrhea as the Only Symptom in a 5 Year Old Boy from Southern Part of India

Paratyphoid fever is a systemic bacterial infection caused by bacteria Salmonella paratyphi serovars A, B, or C. It is most associated with travel to endemic areas but can occur sporadically in non-endemic areas. While the disease is more commonly seen in adults, it can occur in children, and the presentation can be variable. It is clinically difficult to differentiate Typhoid from Paratyphoid without isolation of organism. We present a case of a 5-year-old boy, from Telangana state of South India, who presented with watery diarrhea of 8 to 10 episodes per day and abdominal discomfort for 5 days. At presentation child had some dehydration and very poor oral intake. Child did not respond to standard acute gastroenteritis with some dehydration management and continued to have persistent loose watery stools. Routine blood investigations, urine and stool microscopy revealed normal study. Further evaluation in the second week of illness revealed paratyphi on stool culture, and the child started to respondwithsensitive antibiotic cefotaximeinjections after 3 days of starting. However the child did not have other classical symptoms caused by paratyphi, such as fever, vomiting, or rose spots. Other classical investigations like blood culture and urine culture were negative. This case highlights the importance of considering paratyphoid as a potential cause for persistent diarrhea, even in young children, and the importance of prompt diagnosis and treatment with appropriate antibiotics, especially in the absence of classical clinical or laboratory findings.