Surgery for paratyphoid fever is rarely needed and is reserved only for serious, life-threatening complications that cannot be managed with medication alone. The most common reason for surgery is a perforated intestine, where ulcers caused by the infection create holes in the bowel wall, allowing intestinal contents to spill into the abdomen and cause peritonitis, a severe and dangerous infection. In such cases, immediate surgery is required to repair the perforation and clean the abdominal cavity to prevent sepsis. Another situation that might require surgical intervention is massive intestinal bleeding that cannot be controlled through endoscopic or medical means. Occasionally, surgery may also be necessary if there is intestinal obstruction due to inflammation or scarring that develops after a prolonged or repeated infection. However, these complications are uncommon today because early antibiotic treatment usually prevents the disease from reaching such an advanced stage. Therefore, surgery is typically seen only in patients who have gone untreated for a long time or in regions with limited access to proper medical care.