A 70-year-old male presented to the OPD with complaints of abdominal pain, nausea, headache, malaise, persistent fever for 2 weeks along with constipation. On examination a characteristic rash was observed on the trunk and chest. BP – 120/70 mm of Hg HR- 65 bpm Hepatomegaly Splenomegaly Blood culture did not show any organism, hence a bone marrow culture was taken. Gram staining was done. Biochemical reactions revealed fermentation of glucose with acid production, reduction of nitrates, don’t ferment lactose and were motile by means of flagella. What is the drug of choice if the above organism is a multi-drug resistant variety:-

Correct Answer: Ceftriaxone
Description: This is a case of Salmonella infection. The image shows faint, salmon coloured blanching maculopapular rash located on trunk and chest (Rose spots). Gram stain shows gram negative bacillus. Salmonella Does not ferment lactose Relative bradycardia Typical rash called rose spots Drug of choice - Ciprofloxacin Drug of choice in resistant variety- Ceftriaxone
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