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The sick child was transferred from the Belgrave
Hospital to St. George s Hospital. Tooting, and recovered
from typhoid fever. He received chloramphenicol for 14
days and nine stool and urine cultures were negative
after treatment had ended. His Widal reaction remained
negative throughout the illness.
Mrs. A. and her daughter were also admitted to St.
George's Hospital. Mrs .A. came to this country in 1956,
and in 1960 had an illness diagnosed as acute cholecystitis
she had severe abdominal pain but no headache,
fever or diarrhoea. She was admitted to hospital for a
few days and was discharged free of symptoms She was
re-admitted in October : 1963, after several months of
upper.abdominal pain and flatulence. After investigation
her gall-bladder which was full of stones, was removed,
and she had remained well since then. At St, George's
Hospital Salmonella typhi was isolated from the stools,
but three specimens of urine were negative on culture,
Liver-function tests were normal. Intravenous cholan
giography showed a grossly dilated common bileduct, containing
numerous small calculi. Mrs. A. would not consent
to an operation for removal of her gall-stones.
Mrs. A's daughter was a healthy girl with no significant
past illness. The presence of S typhi in her
stools was confirmed and three specimens of urine were
sterile on culture.
The patient was given ampicillin 2 g. daily for 14
days. After this, six specimens of stools and three
specimens of urine were negative on culture.
Repeated faecal examination of home contacts though
presenting difficulties and with some lack of cooperation
revealed no other carriers., and it seems
that Mrs. A infected the child and her own child. No
history could be obtained from Mrs, A of illness in the
West Indies before 1956 suggestive of typhoid. The
episode in 1960 may well have been a typhoid cholecystitis
followed by the formation of gall-stones, which
were removed in 1963.
Mrs. A was discharged from hospital early in March
but was still receiving treatment as an out patient.
Precautions were taken to ensure that she did not return
to work in a food factory and she was found alternative
employment.