The first Canadian pediatric case of extensively drug-resistant Salmonella Typhi originating from an outbreak in Pakistan and its implication for empiric antimicrobial choices

•Third-generation cephalosporins are common first line agents to empirically treat typhoid fever.•An outbreak of extensively-drug resistant (XDR) typhoid has emerged in Pakistan that is resistant to ceftriaxone.•This is the first Canadian case of XDR typhoid in a child who travelled to Pakistan and was successfully treated with 2 weeks of meropenem.•Clinicians should consider adapting their empiric management of typhoid for travellers returning from XDR regions.