Salmonella Typhi (S.Typhi) is the causative agent in typhoid fever. In Pakistan, an extensive drug-resistant (XDR) S.Typhi strain has emerged that is resistant to all recommended antibiotics, including third-generation cephalosporins. We report the case of a 29-year-old pregnant woman presenting with high-grade fever, lower abdominal pain, concerns of urinary burning, and increased urinary frequency lasting four days. Blood cultures confirmed XDR S. Typhi. This case highlights three important items: the emergence of the XDR typhoid strain in an unstudied community, the susceptibility of immunocompromised individuals to infectious diseases, and the role health care practitioners can play in controlling its spread regionally and globally.
Keywords: antibiotic resistance; enteric fever; infectious diseases; pakistan; public health; s typhi; xdr typhoid.