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environment. In this patient, typhoid encephalitis is presumed 4. Boodosingh DR, Robles-Arias C, Alemán-Ortiz JR, Rodríguez-
given clinical presentation and course, positive typhoid test- Cintrón W. A rare cause of altered mental status and fever in a
ing, and a 96-hour delay to lumbar puncture following empiric young military recruit in Puerto Rico. P R Health Sci J. 2014;33(4):
treatment with subsequent improvement. 200–202.
5. Jeong PS. Recognizing moyamoya disease in a Soldier with recur-
rent cerebrovascular symptoms. Mil Med. Published online Janu-
Author Contributions ary 22, 2022. doi:10.1093/milmed/usab564
IB conceived of the case study and wrote the first draft. All the 6. Mellon G, Eme AL, Rohaut B, Brossier F, Epelboin L, Caumes
authors reviewed and provided critical edits and contributions E. Encephalitis in a traveller with typhoid fever: efficacy of cor-
to the final manuscript. ticosteroids. J Travel Med. 2017;24(6):10.1093/jtm/tax063.
doi:10.1093/jtm/tax063
Disclosures 7. Henderson A, Knight RJ, Livesey JR. Typhoid masquerading as
None Japanese encephalitis. J R Army Med Corps. 1984;130(3):183–
184. doi:10.1136/jramc-130-03-07
Disclaimer 8. Hancuh M, Walldorf J, Minta AA, et al. Typhoid fever surveil-
The views expressed are those of the authors and do not reflect lance, incidence estimates, and progress toward typhoid conju-
gate vaccine introduction – worldwide, 2018–2022. MMWR
the official policy of the Department of Army, the Department Morb Mortal Wkly Rep. 2023;72(7):171–176. doi:10.15585/
of Defense, or the U.S. Government. mmwr.mm7207a2
9. Olsen SJ, Bleasdale SC, Magnano AR, et al. Outbreaks of ty-
Funding phoid fever in the United States, 1960–99. Epidemiol Infect.
No funding was received for this work. 2003;130(1):13–21. doi:10.1017/s0950268802007598
10. Venkatesan A, Tunkel AR, Bloch KC, et al. Case definitions, diag-
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