The Relapse State in Typhoid Fever Treated with Chloramphenicol

Kenneth C. Watson Department of Pathology, Medical School, University of Natal, Durban, Natal, South Africa

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The incidence of relapse in typhoid fever treated with chloramphenicol is dependent on the period of time during which therapy is continued. Where this is less than about seven days very high relapse rates may be experienced. The relapse state is probably initiated by intracellular forms of S. typhi present in reticuloendothelial cells. It is suggested that chloramphenicol promotes phagocytosis of viable organisms and that this creates a reservoir of tissue forms of the organism which is responsible for the high relapse rates in those patients who are inadequately treated.

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