Travel associated extensively drug resistant typhoid fever: a case series to inform management in non-endemic regions.

XDR typhoid fever is a particular risk for travelers to Pakistan, and empiric use of a carbapenem or azithromycin should be considered. Pre-travel typhoid vaccination and counseling are necessary and urgent interventions, especially for VFR travelers. Ongoing sentinel surveillance of XDR typhoid fever is needed to understand changing epidemiology.