Abstract
Introduction: Typhoid fever is a potential febrile illness caused by Salmonella enterica serovar Typhi. It is mainly transmitted through contaminated food and water, and spreads from infected persons and chronic carriers. Humans are the only reservoir host. There were many multi-drug resistant S. Typhi cases reported in many parts of South Asia and Africa. However, since 2016there were reported case series of extended drug resistant S. Typhi from Pakistan (resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, fluoroquinolones and third generation cephalosporines). Genomic sequencing analysis of this organism was of haplotype H58 transmitted by a plasmid. Case Presentation: This is the first reported case of ceftriaxone-resistant typhoid fever in the Middle-East, who travelled from Pakistan to Qatar in September 2019. He recovered completely with injection meropenem and oral azithromycin. Conclusion: A detailed travel history and early diagnosis and treatment with appropriate drugs are inevitable in the management of such cases. Safe drinking water, improved sanitation and effective public health infrastructure will play a key role in the control of the disease.
Highlights
Typhoid fever is a potential febrile illness, caused by Salmonella enterica serovar Typhi, which is most commonly seen in South-East Asia and Africa
Case Presentation A 44-year-old man returned from Lahore, Pakistan, with a history of high-grade fever for 10 days with severe headache, fatigue and loss of appetite
Typhoid fever is caused by gram-negative organism, S. enterica serovar Typhi
Summary
Typhoid fever is a potential febrile illness, caused by Salmonella enterica serovar Typhi, which is most commonly seen in South-East Asia and Africa. Case Presentation A 44-year-old man returned from Lahore, Pakistan, with a history of high-grade fever for 10 days with severe headache, fatigue and loss of appetite. He was started on cefixime (400 mg) -BID by a local doctor. From day 1 of admission, high-grade fever with shivering and severe headache was recorded every 6 hours which continued in spite of taking antipyretic medication. His serum C-reactive protein and liver enzymes were elevated. His serum C-reactive protein level reduced to near normal (Table 2)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
