A 58-year-old woman who recovered from typhoid fever 20 years ago continues intermittent low-grade fever. Stool cultures repeatedly grow Salmonella Typhi over successive months. The anatomical site most commonly harboring the organism in such chronic carriers is the:

• A Gallbladder ✓
• B Terminal ileum Peyer patches
• C Renal pelvis
• D Bone marrow

Explanation

Chronic carriage of Salmonella Typhi, defined as fecal shedding beyond one year, occurs in a small percentage of patients, more often women and those with biliary disease. The organism persists in the gallbladder, frequently within gallstones, and is shed intermittently in bile into the stool. Cholecystectomy combined with antibiotics may be required for eradication. Peyer patch persistence explains acute ulceration during active illness, not long-term carriage.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.