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September 10, 1997

Typhoid Fever

Author Affiliations

From the Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Md.

JAMA. 1997;278(10):847-850. doi:10.1001/jama.1997.03550100073042

CASE PRESENTATION  A 35-year-old Maryland woman came to her local hospital on December 4, 1994, complaining of fever and chills for 1 week. She was 25 weeks pregnant. Four weeks earlier, she and her husband and young daughter had visited relatives in a city about 320 km northwest of Bombay, India. She had not received pretravel vaccinations or malaria prophylaxis, and she did not take any specific food or water precautions while in India. She had felt well during the trip. She had returned to Maryland on November 24.On November 29, she developed fever and chills. Her private physician examined her that day and prescribed oral ampicillin to treat a sore throat. When her fever persisted, she was admitted to the local hospital on December 4. Evaluation included blood cultures and multiple Giemsa-stained thick smears for malaria. On December 5, a physician diagnosed malaria after identifying a Plasmodium falciparum parasite