Typhoid is an acute febrile illness primarily caused by Salmonella enterica serotype typhi (S. Typhi) which
could be challenging to diagnose in children, owing to its non-specific clinical signs and symptoms which
may resemble other febrile illnesses. Here, we present a case of typhoid which was atypically presented as
fever of unknown origin (FUO) in a two-year-old boy with underlying glucose-6-phosphate dehydrogenase
(G6PD) deficiency. This child was initially diagnosed and managed as acute tonsillopharyngitis, however
remained febrile despite medications. A series of investigations were performed and S. Typhi was
isolated from the bone marrow culture after almost a month of admission. The antibiotic was started
based on antibiotic susceptibility testing and he recovered well. Our case underscores the challenges of
diagnosis establishment and clinical management of typhoid in paediatric patients who has underlying
disease and emphasizes the importance of having high index of clinical suspicion to ascertain timely
and proper diagnosis.