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Key Features

  • This complication tends to occur in immunocompromised persons, eg, HIV-infected individuals, who typically have bacteremia without an obvious source

Clinical Findings

  • May be manifested by prolonged or recurrent fevers or by local infection in bone, joints, pleura, pericardium, lungs, or other sites

  • Gastrointestinal symptoms not a prominent feature

  • Mycotic abdominal aortic aneurysms may be a complication

Diagnosis

  • Serotypes other than Salmonella typhi usually are isolated in culture of blood, bone marrow, or site of infection

Treatment

  • Treatment is the same as for typhoid fever (see Enteric Fever [Typhoid fever]) plus drainage of any abscesses

  • In HIV-infected patients, relapse is common, and lifelong suppressive therapy may be needed

  • Ciprofloxacin, 500 mg twice daily orally, is effective both for treatment of acute infection and for suppression of recurrence

  • Drug-resistant (fluoroquinolones and ceftriaxone) strains are increasing in prevalence

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