Recurrent Salmonella typhi Bacteremia 47 Years After Typhoid Fev
Vaccines are available to prevent typhoid fever; antibiotics are able to manage the disease. Yet, some patients who are treated for typhoid fever become chronic carriers of Salmonella typhi. Backlash can occur many years after the initial infection, as we report in the case of a man with repercussions from the disease 47 years later.

Typhoid fever is a common infection in developing countries. Between 2% and 5% of treated persons remain chronically infected and excrete the causative organism, Salmonella typhi, in their feces, thus providing an important reservoir that can lead to outbreaks in those who consume fecally contaminated food and water. Remarkably, chronic carriers are asymptomatic and clinically well. We present an exception to this typical pattern -- a patient who apparently harbored S typhi for 47 years as an asymptomatic, chronic carrier and then experienced 2 episodes of symptomatic S typhi bacteremia associated with metastatic adenocarcinoma and chemotherapy.