Ataxia in patients infected with Salmonella typhi phage type D2: clinical, biochemical and immunohistochemical studies

Reversible cerebellar dysfunction has been described in association with typhoid fever by a number of authors. Ataxia and tremors are relatively common manifestations of typhoid fever in Papua New Guinea. A series of 14 patients with typhoid fever and ataxia was compared with non-ataxic typhoid patients. Hyponatraemia and hypoalbuminaemia were common in both groups and more severe in the ataxic group. Hypotension was also more common in the ataxic group. These features may reflect more severe disease. All isolates of Salmonella typhi, from both ataxic and non-ataxic patients, were phage type D2 which is endemic around Port Moresby. Tests for autoantibodies cross-reacting with cerebellar tissue were negative. It is possible that cerebellar dysfunction in typhoid fever is more common in association with phage type D2.