American Board of Internal Medicine (ABIM) Certification Practice Exam

What is commonly seen in patients with typhoid fever?

1. Tender hepatosplenomegaly

2. Hypotension

3. A red rash on the abdomen

4. Severe cough

The correct answer is: Tender hepatosplenomegaly

In patients with typhoid fever, tender hepatosplenomegaly is commonly observed due to the systemic infection caused by Salmonella typhi. This organism leads to a febrile illness, and as the infection progresses, it often affects the liver and spleen, causing them to enlarge. The tenderness in these organs can stem from the inflammatory response elicited by the infection, resulting in symptoms like discomfort or pain in the upper left abdomen. Other symptoms associated with typhoid fever include sustained fever, abdominal pain, and gastrointestinal complications, but tender hepatosplenomegaly is particularly significant as it reflects the underlying pathophysiology of the disease. The involvement of the liver and spleen is part of a broader systemic effect that showcases the severity of the infection and its potential complications.