Infect Chemother.  2008 Jun;40(3):175-178. 10.3947/ic.2008.40.3.175.

A Case of Typhoid Fever to Failed Ciprofloxacin, Infected in Korea

• Lee KS
• Lee HY
• Jeon EJ
• Chung JW

• KMID: 1782292
• DOI: http://doi.org/10.3947/ic.2008.40.3.175

Abstract

Typhoid fever caused by Salmonella enterica serovar Typhi (S. typhi) and usually ciprofloxacin is first used for treatment. However, the incidence of fluoroquinolone resistance or reduced susceptibility in S. typhi has been increased in Asia over the past decade and there have been reports of failed treatment with ciprofloxacin. Recently, if typhoid fever does not improved with ciprofloxacin treatment, S. typhi with reduced susceptibility to ciprofloxacin should be considered. We experienced a case of nalidixic acid-resistant S. typhi infection that was refractory to treatment with ciprofloxacin in Korea. A 47-year-old woman presented with fever and headache for 14 days. Blood culture revealed the presence of S. typhi that was susceptible to ciprofloxacin. However, she remained feverish and new symptoms of abdominal pain and bloody diarrhea developed after 5 days treatment with ciprofloxacin and subsequent testing showed that isolate was resistant to nalidixic acid.

Keyword

Salmonella enterica serovar Typhi; Resistance; Ciprofloxacin; Nalidixic acid

MeSH Terms

Abdominal Pain
Asia
Ciprofloxacin
Diarrhea
Female
Fever
Headache
Humans
Incidence
Korea
Middle Aged
Nalidixic Acid
Salmonella typhi
Typhoid Fever
Ciprofloxacin
Nalidixic Acid

Figure

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  Fig. 1 MIC pf malidoxic acid against S. typhi isolated from case patient was MIC 64 µg/mL by E-test.

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  Fig. 2 Edematous mucosal changes, multiple discreted ulceration with yellowish exudates and petechial hemorrhage are showed in colon mucosa.

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