A Case of Protracted Carrier of Typhoid Bacilli, Who Continued to Excrete Bacilli Even after Cholecystectomy

Abstract

Cholecystectomy was performed on a protracted carrier of typhoid bacilli, in whom oral administration of Chloromycetin had proved to be ineffective. The removed gall bladder showed no other macroscopic change than that it contained a small gallstone. From the bile typhoid bacilli were recovered almost in a pure culture
However, typhoid bacilli continued to be excreted even 7 months after the operation, and could be cultured from the bile and the stool.
Fifteen reported cases of cholecystectomized carriers in Japan were summarized and investigated on the presence of typhoid bacilli in C bile, the changes in the gall bladder and the results of cholecystectomy. It was concluded that cholecystectomy was not an adequate procedure to eliminate typhoid bacilli of the carriers, who had the source of bacilli in the liver or had nearly normal gall bladder.
The author referred to the excellent results obtained by W. Briihl, who treated 4 cases of typhoid and paratyphoid carriers with the application of gall bladder fistula and the perfussion of the bile duct with Chloromycetin solution. His method was recommended for the treatment of typhoid and paratyphoid carriers, who did not respond to internal therapies.