Which combination of signs is classic for enteric fever caused by Salmonella Typhi?

• A. Prolonged fever with stepwise pattern, abdominal pain, hepatosplenomegaly, relative bradycardia, and sometimes rose-colored spots on trunk
• B. Sudden high fever with severe diarrhea only
• C. Rash and cough without fever
• D. Abdominal pain with vomiting but no fever

Answer: (D)

Enteric fever from Salmonella Typhi typically presents with a prolonged fever that rises in distinct steps, along with abdominal pain and hepatosplenomegaly. A noticeable feature is relative bradycardia, where the pulse is slower than expected for the fever. The trunk may show rose-colored spots as well. This combination—stepwise fever plus systemic signs and rose spots—is classic for Typhi fever and helps distinguish it from other febrile illnesses that cause high fever with diarrhea, rash without fever, or abdominal pain without fever.