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Typhoid Fever

more about Typhoid Fever


Enteric fever


  • Typhoid fever is an infection caused by bacteria that is spread through contaminated food.  The bacteria enter the host through the intestinal system, and migrate to other parts of the body through the bloodstream.  Prevention is the best strategy.  However, if infection does occur, antibiotics will be needed.

  • Symptoms usually begin with a headache, sore throat, cough, fatigue, abdominal pain, and constipation.  Also, the infected party will usually have a low-grade fever.
  • Within about 7 to 10 days, the patient becomes much more ill with increasing fever, extreme exhaustion, severe constipation or "pea soup" Diarrhea, and distended stomach.
  • Usually, the patient will get better over the next 7-10 days.
  • When examined, enlarged spleen, distended abdomen, Slow Heart Rate, and neck stiffness may be detected. Also, there may be a rash (described as "rose spots") that appears during the second week of the illness.  This rash may last for a few days.
  • Some people may become extremely ill.  Severe complications may develop, including Shock, intestinal bleeding, holes in the intestine, Pneumonia, or psychotic behavior. Infections of the heart, kidneys, gallbladder, bones, or brain are additional possible complications.

  • The cause of the disease is a bacterium known as Salmonella typhi.  Once it enters the host, it spreads via the bloodstream and begins to multiply in different parts of the body, including the lungs, kidneys, gallbladder, and brain.

  • Diagnosis is made by Blood culture tests that detect the bacteria.  Stool culture tests are not as useful.
  • If all the Blood cultures are normal, a sample of bone marrow may be sent for testing.

  • Once one contracts the infection, he will need to be treated with antibiotics, given intravenously or by mouth, depending on the severity of the illness.
  • The antibiotic most often used is Trimethoprim-sulfamethoxazole.  Other antibiotics that may be used are Ceftriaxone and Ciprofloxacin (but this should not be used in children and pregnant women).  Ampicillin and Chloramphenicol may also be used, but they are often not effective.
  • Treatment needs to be continued for 2 weeks.
  • Up to 2% of people who develop typhoid fever die.  Older patients and those with other medical conditions have a higher risk of death.  Children usually do fine with treatment.
  • Repeat infections occur in up to 15% of those treated.
  • People who develop complications have a much higher risk of dying.

  • Prevention of the infection is the main key to controlling this disease.  Vaccines are available, but they are not always successful.  People in contact with infected individuals, and those who are travelling to areas where the infection is common, should be immunized.  Also, if there is an epidemic, vaccinations should be given.
  • Vaccines can be administered by injection or taken by mouth.  The oral vaccine has fewer side effects.  Booster doses are needed 5 years after the oral vaccine, and 3 years after the injected vaccine.
  • Anyone who is infected should not be allowed to work around food.
  • Also, good hygiene is essential in preventing the infection.


  • Special Information
    1. Some people carry the bacteria but do not become sick.  They can, however, spread the infection to others.  They are known as carriers, and they definitely should not be allowed to prepare or handle food.
    2. These people need to be treated with antibiotics to remove the bacteria from their body.  750 milligrams of Ciprofloxacin taken twice a day for four weeks is most often (but not always) effective.
    3. Also, in some, removal of the gallbladder has proven to be necessary and effective in eliminating the bacteria.





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