Answer to Photo Quiz: Enteric Fever (See page 1053 in this issue doi:10.1128/JCM.01412-13 for photo quiz case presentation.)

摘要

Manual and automated phenotypic methods identified the lactose-nonfermenting blood culture isolate as a Salmonella species. Subsequent serotyping of the isolate by use of O and Vi group D antisera definitively identified it as Salmonella enterica subsp. enterica serovar Typhi, the etiologic agent of typhoid fever. A distinguishing feature of S. Typhi, which is evident in Kliger iron agar and triple sugar iron agar slants, is an alkaline slant, an acid butt, a lack of gas production, and a small amount of hydrogen sulfide that is limited to the stab line and the area where the agar was punctured (1). This feature alone is often sufficient for a preliminary identification of S. Typhi, since most nontyphoidal sal-monellae produce hydrogen sulfide that is dispersed throughout the butt of these media.