Which clinical finding is sometimes observed in enteric fever due to Salmonella Typhi?

• A. Rose-colored spots on the trunk
• B. Rash on the face only
• C. Bloody diarrhea as the sole feature
• D. Jaundice without other symptoms

Answer: (C)

In enteric fever caused by Salmonella Typhi, a clue you may see is a rose-colored maculopapular rash on the trunk. These tiny pink lesions typically appear during the second week of fever, blanch with pressure, and are most evident on the abdomen and chest. They reflect a vasculitic or immune-mediated process and, while not present in everyone, are a classic feature that can help distinguish typhoid from other febrile illnesses.

Other patterns listed don’t fit as well. Rash limited to the face is not typical of typhoid. Jaundice by itself is not a defining feature in uncomplicated enteric fever. Bloody diarrhea as the sole feature isn’t characteristic of typhoid fever, where diarrhea, when it occurs, is not usually the sole or dominant presentation in the same way as in other invasive enteric infections.