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Case Report
Acute G6PD deficiency haemolytic crises with associated methaemoglobinaemia in a patient with typhoid
Southern African Journal of Infectious Diseases | Vol 41, No 1 | a771 |
DOI: https://doi.org/10.4102/sajid.v41i1.771
| © 2026 Jake P. Jacob, Midhun T. John, Gilad Mensky, Lior Chernick
| This work is licensed under CC Attribution 4.0
Submitted: 11 July 2025 | Published: 13 January 2026
Submitted: 11 July 2025 | Published: 13 January 2026
About the author(s)
Jake P. Jacob, Department of Infectious Diseases, Faculty of Health Sciences, Helen Joseph Hospital, Johannesburg, South Africa; and, Department of Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaMidhun T. John, Department of Infectious Diseases, Faculty of Health Sciences, Helen Joseph Hospital, Johannesburg, South Africa; and, Department of Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Gilad Mensky, Department of Infectious Diseases, Faculty of Health Sciences, Helen Joseph Hospital, Johannesburg, South Africa; and, Department of Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Lior Chernick, Department of Infectious Diseases, Faculty of Health Sciences, Helen Joseph Hospital, Johannesburg, South Africa; and, Department of Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder that increases red blood cell susceptibility to oxidative damage. While haemolysis is common, methaemoglobinaemia is a rare complication. A 39-year-old man developed both conditions, triggered by Salmonella typhi infection. Diagnosis was supported by Heinz bodies and blister cells on blood smear. Methylene blue and high-dose ascorbic acid were relatively contraindicated because of ongoing haemolysis and renal dysfunction.
Contribution: This case highlights the importance of considering methaemoglobinaemia in G6PD deficiency during infections and adapting treatment when standard therapies are unsuitable.
Keywords
G6PD deficiency; haemolytic crises; methaemoglobinaemia; typhoid
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