A 25-years-old female presents with High Grade Pyrexia for ten days, develops acute pain in periumbilical region spreading all over the abdomen. What would be the most likely cause?

Diagnosis is Enteric Fever or Typhoid Fever and abdominal pain are hallmark symptoms Non-specific symptoms: Headache, cough, sweating, myalgia, ahralgia, fatigue Paralytic ileus is the MC complication of typhoid Intestinal hemorrhage (2nd MC) may be the leading symptom Characteristic signs Rose spots, splenomegaly, leucopenia with shift to left Relative bradycardia despite of high fever TB is Less likely as History doesn't mention Low Grade fever, Night Sweating, Weight loss . Appendicular perforation is an acute condition with Shifting of pain to Right Illiac Fossa.