Enteric Fever in Children

A 5-year-old girl from Chennai presents with a 14-day history of fever, abdominal distension, and loose stools. Her parents report that she has been lethargic and not eating well. On examination, temperature is 38.8°C, she appears toxic, and has a palpable spleen 3 cm below the costal margin. Abdomen is mildly distended with no guarding. Blood culture grows Salmonella typhi. Stool culture is also positive for the same organism. What is the most important clinical implication of the positive stool culture in this case?

What is the antibiotic of choice for uncomplicated enteric fever in children in India, considering current resistance patterns?

A 7-year-old boy from rural Uttar Pradesh presents with a 10-day history of high-grade fever (39.5°C), abdominal pain, and constipation. On examination, he has hepatosplenomegaly and a faint rose-coloured rash on the trunk. Blood culture is pending. Complete blood count shows Hb 11.2 g/dL, WBC 6,500/μL with relative lymphocytosis, and platelets 120,000/μL. Widal test shows O antigen titre of 1:320 and H antigen titre of 1:160. What is the most likely diagnosis?

Which organism is the most common cause of enteric fever in children in India?