A 48-year-old woman who worked as a cook is investigated after several household members develop enteric fever. She reports an episode of typhoid fever three years ago treated incompletely. Stool culture now grows Salmonella typhi on three successive samples over one month. The anatomical site most commonly responsible for her chronic carrier state is:
- A Persistent infection of the gallbladder, often with gallstones ✓
- B Chronic gastric atrophy with achlorhydria
- C Colonic crypt abscesses harboring intracellular bacteria
- D Chronic prostatitis with biofilm formation
Correct answer: A. Persistent infection of the gallbladder, often with gallstones
Explanation
B chronic typhoid carrier is defined as excretion of S. typhi in stool for more than one year after acute illness. Bacteria persist in the gallbladder, where bile supports their growth and gallstones provide a surface for biofilm formation; the biliary tract continuously seeds the intestine. This is the basis for treating carriers with cholecystectomy combined with prolonged antibiotics such as ciprofloxacin or ceftriaxone. Achlorhydria increases susceptibility to infection but does not sustain carriage.
Reference: Harrison Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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