Typhoid fever is classically associated with which finding?

• A. Water diarrhea without systemic symptoms
• B. Rash on palms
• C. Jaundice
• D. Rose spots on the trunk

Answer: (D)

Typhoid fever has a distinctive skin finding called rose spots. These are small, salmon-pink macules on the trunk that blanch with pressure and are most often seen during the second week of illness. They are a classic clue that points toward Salmonella typhi infection, especially in the right clinical context of fever, abdominal pain or constipation, and hepatosplenomegaly.

Water diarrhea without systemic symptoms isn’t typical for typhoid, which usually features fever and systemic signs more prominently. A rash on the palms isn’t characteristic of typhoid (palmar rashes are seen with other conditions like certain rickettsial infections or secondary syphilis). Jaundice can occur with liver involvement but isn’t the classic or most distinctive finding. The rose spots on the trunk are the hallmark feature that best identifies typhoid fever.