Enteric fever in a child of immigrant parents to USA

A boy of 8 years, a child of immigrant parents to USA, who recently came to visit Bangladesh presented with fever, abdominal pain and vomiting.
He had no definite tenderness in the abdomen and no other abnormal finding. Other members of the family had viral fever in the recent past.

Initially the child was thought to be a case of viral fever. But as the fever was not subsiding as that of others, investigations were done. Widal test showed strongly positive (TO 1:320), in ICT for Salmonella IgM was positive but not the IgG, MP in blood film and in ICT was negative.

The Patient was treated with Injection Ceftriaxone and supplemented by oral Azithromycin Response was slow. Initially vomiting stppped, then the abdominal pain, fever took 6 days to come to the base line after introduction of Ceftraixone. He had fever for total 11 days

We continue Ceftriaxone for 4 afebrile days and Azithromycin for 5 afebrile days.


Bdoza