Fever in a Traveler

We presented a 26 year old female with chills and fever to 40.5C. She says symptoms began 1 week ago after she completed a marathon and had 3 days of intermittent fevers and chills. She was seen at student health and noted to have thrombocytopenia and elevated CRP and refused to go to ED due to a test coming up. She felt better briefly but then rapidly her symptoms returned. She was in El Salvador the previous month, reports she had a few days of watery diarrhea but otherwise was fine. No vaccinations prior to her trip. H She had mild transaminitis and mild anemia on labs. Specialized work up revealed blood cultures positive for salmonella typhi. She responded well to IV ceftriaxone.


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