A retrospective case note review was undertaken to assess the clinical sign
ificance of hepatic dysfunction with jaundice in typhoid fever. Of the 57 p
atients, 21 (36.8%) had jaundice, while 36 (63.2%) did not have jaundice. S
ignificantly higher proportions of jaundiced patients were females (P = 0.0
4). Confusion (P = 0.01), upper abdominal pain (P = 0.02), right upper quad
rant tenderness (P = 0.0001), and low prothrombin index (P = 0.04) were sta
tistically significant occurrences in jaundiced patients on admission. Admi
ssion mean values of serum bilirubin (P = 0.0001), gamma-glutamyltranspepti
dase (GGT; P = 0.009), and alanine aminotransferase (ALT; P 0.0005) were si
gnificantly higher in icteric patients while mean values of total serum pro
tein (P 0.0009) and albumin (P = 0.0001) were significantly higher in anict
eric patients. There were no deaths. Glomerulonephritis occurred significan
tly (P 0.001) more frequently in icteric patients. It is concluded that hep
atic dysfunction with jaundice in typhoid fever indicates more severe hepat
ic injury, which may precipitate the development of clinically detectable g
lomerulonephritis.