A 58-year-old woman had documented Salmonella Typhi bacteraemia three years ago. She now reports intermittent low-grade fever and stool cultures again grow S. Typhi. She has no diarrhoea. Excretion of the organism for more than one year defines a chronic carrier, and the anatomical site most commonly harbouring the organism in such carriers is the:

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

Explanation

Chronic carriage is defined as faecal excretion of S. Typhi for more than 12 months after acute illness and occurs in roughly 1 to 4 percent of patients. The organism persists in the gallbladder, often in association with gallstones or chronic cholecystitis, and is shed intermittently in bile into the stool. Urinary carriage occurs mainly in patients with schistosomiasis, and bone marrow involvement relates to active disease, not chronic shedding.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.