1. Salmonella typhi septicemia (Typhoid Fever)

2. Complaint- A constant, throbbing left parietal headache for four to five days. - He also had intermittent, generalized sweating accompanied by chills, fatigue, malaise, myalgias, and arthralgias for two to three days. Malaise- feeling of discomfort Myalgia- pain in a muscle Arthralgia- pain in a joint

3. Medical History- Unremarkable - No vaccinations was received prior to his trip to India and was never vaccinated for previous visits

4. Laboratory tests: Normal electrolytes Normal White blood cell count Normal chest x-ray Serologic tests for Epstein Barr virus and Borrelia burgdorferi were negative Serologic test- a blood test to detect the presence of antibodies against a microorganism. Epstein Barr virus- a herpes virus causing infectious mononucleosis and associated with certain cancers Borrelia burgdorferi- cause of Lyme disease

5. When presented to the ED - Had three days of watery diarrhea toward the end of his time in India. - Ate at restaurants fifty percent of the time during his trip - He was mildly pancytopenic with a white blood cell count - Malaria smear was performed and was negative Pancytopenia- is an abnormally low level of all blood cells produced by the bone marrow. This includes a low level of RBCs, WBCs, and platelets.

6. Final Diagnosis: Salmonella typhi septicemia (Typhoid Fever) - Patient showed clinical improvement with resolution of laboratory abnormalities after 4-5 days of ciprofloxacin - Discharged on oral ciprofloxacin to complete a two-week course Medicine: Ciprofloxacin- is used to treat bacterial infections in many different parts of the body