Enteric fever (formerly typhoid fever) is a bacterial illness caused by fecal-oral transmission of or . In early 2018, an outbreak of resistant to third-generation cephalosporins, ampicillin, ciprofloxacin, trimethroprim-sulfamethoxazole, and chloramphenicol was reported in Pakistan. This strain, termed "extensively resistant typhi," has infected more than 5000 patients in endemic areas of South Asia, as well as travelers to and from these areas, including 5 cases in the United States. We present the case of one such child who developed extensively resistant enteric fever during a recent visit to Pakistan and required broader antimicrobial treatment than typically required. Clinicians should be aware that incoming cases of enteric fever may be nonsusceptible to commonly recommended antibiotics and that extensively resistant requires treatment with carbapenems such as meropenem or azithromycin.

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http://dx.doi.org/10.1177/0009922819881203DOI Listing

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