Enteric fever is a community-acquired generalized bacteremic infection of the topical countries where health infrastructure and hygienic conditions are compromised to a great extent due to poor public health facilities and low socioeconomic status. It is associated with the involvement of the reticuloendothelial system, intestinal lymphoid tissue, and even the gallbladder. Ever-increasing antimicrobial resistance, increasing number of cases in younger children, and increasing paratyphoid cases are the current challenges. Though the management of typhoid fever is straight forward, it poses a number of diagnostic challenges and dilemma due to many reasons which include lack of sensitivity and specificity of clinical features and CBC parameters, overreliance on serology despite its limitations, non-feasibility of culture methods, underutilization of blood culture despite its availability, and poor yield due to prior antibiotic therapy. Classic presentation may not be always there. CBC has more of a negative predictive value. Blood culture is the gold standard but may not always be feasible and results are available by day 4. A rapid, point-of-care test with very good sensitivity and specificity is needed to detect acute cases as well as carriers.
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