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A Case of Typhoid Fever Failed to Ciprofloxacin, Infected in Korea
Kwang Sun Lee, M.D., Ha Yeon Lee, M.D., Eun Ju Jeon, M.D. and Jin Won Chung, M.D.
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
Vol.40 Num.3 (p175~178)
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.
Keywords : Salmonella enterica serovar Typhi, Resistance, Ciprofloxacin, Nalidixic acid