Typhoid myopathy or typhoid hepatitis: a matter of debate.

Purpose: The aim of the present study was to evaluate the major source of increased serum enzyme level in typhoid fever and to determine the most relevant clinical entity, hepatitis or myopathy, during typhoid fever.

Methods: A total of 118 subjects proved to have typhoid fever were evaluated for serum enzymes such as transaminases, alkaline phosphatase, lactate dehydrogenase (LDH) and creatinine kinase (CK); and their relation with each other, clinical symptoms and serum bilirubin were evaluated by regression methods.

Results: Hepatomegaly was revealed in 14% of the cases and was correlated with elevated serum biliribin (5.05 +/- 13.03 mg/dL in hepatomegalic subjects). Alanine aminotransferase (ALT) and CK were elevated in 22 and 60% of the cases, respectively. Correlation coefficient of CK with aspartate aminotransferase (AST) and LDH was R2 = 0.68 and 0.75, respectively, which were higher than that of ALT with that two enzymes.

Conclusions: In conclusion, elevation of serum enzymes in typhoid is mostly of muscular origin.