Recent travel with fever, cough, abdominal pain, constipation, prostration, bradycardia followed by rose spots on trunk.

• A. Dengue Fever
• B. Typhoid Fever
• C. Malaria
• D. Yellow Fever

Answer: (B)

This item tests recognizing enteric fever features after travel, especially the combination of abdominal symptoms, constipation, prostration, and a distinctive skin finding. Typhoid fever from Salmonella Typhi commonly presents with fever and deep malaise, abdominal pain, and constipation early in the illness. A clue is the relative bradycardia, or Faget sign, where the heart rate is slower than expected for the fever. The rose spots on the trunk—pink to red macules that blanch—are a classic, though not always present, clue that points toward typhoid. Taken together, these elements make typhoid fever the best explanation.

Dengue typically shows high fever with severe joint and muscle pains and often a different rash pattern, usually with tachycardia rather than bradycardia. Malaria features cyclic fevers and often splenomegaly and anemia, with a rash like rose spots being unusual. Yellow fever includes jaundice and hepatic symptoms rather than the trunk rose spots common in typhoid.