In addition, noninfectious cases of febrile illness, such as lymphoma, also should be considered. The duodenal string test may be used to culture bile. Anemia and thrombocytopenia may be present. Elevated liver function tests are common. Renal dysfunction may occur, but chronic renal failure has not been reported.
Abdominal radiographs demonstrate free air in cases of intestinal perforation.
S typhi is a motile, gram-negative bacillus. The current DOC for adults is oral ciprofloxacin, which combines little documented resistance with excellent penetration into macrophages and the biliary system. This may reduce the rate of relapse and chronic carrier states. Alternative antibiotics can be used if sensitivities are known or suspected resistance is low. The current DOC for children and pregnant women is parenteral ceftriaxone.