Typhoid Fever also known as Enteric Fever. It is an acute illness associated with fever caused by the Salmonella typhi bacteria. It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness. The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area.
Signs and Symptoms
1. In the First Week :
- Temperature rises slowly (Stepladder pattern)
- Headache
- Abdominal pain
- Malaise
- Cough
- Relative bradycardia
- Widal test is negative in the first week.
2. In the Second Week :
- Fever ( around 104 °F)
- Delirium
- Bradycardia
- Hepatosplenomegaly
- Rose spots appear on the lower chest and abdomen in around a third of patients
- Abdominal pain
- Diarrhea
3. In the Third Week :
- Intestinal haemorrhage due to bleeding in congested Peyer's patches
- Intestinal perforation in the distal ileum
- Encephalitis
- Metastatic abscesses
4. In the Fourth Week :
- By the end of third week, the fever starts subsiding (defervescence). This carries on into the fourth and final week.
Exams and Tests
1. A complete blood count (CBC) will show a high number of white blood cells.
2. A blood culture during the first week of the fever can show S. typhi bacteria.
3. Other tests that can help diagnose this condition include:
- ELISA urine test to look for the bacteria that cause Typhoid fever
- Fluorescent antibody study to look for substances that are specific to Typhoid bacteria
- Platelet count (platelet count may be low)
- Stool culture
Treatment
1. Fluids and electrolytes may be given by IV (into a vein). Or you may be asked to drink uncontaminated water with electrolyte packets.
2. Antibiotics are given to kill the bacteria, the treatment of choice is a fluoroquinolone such as ciprofloxacin. Otherwise, a third-generation cephalosporin such as ceftriaxone or cefotaxime is the first choice. Cefixime is a suitable oral alternative.
3. When untreated, typhoid fever persists for three weeks to a month. Death occurs in between 10% and 30% of untreated cases. In some communities, however, case-fatality rates may reach as high as 47%.
4. Surgery : Surgery is usually indicated in cases of intestinal perforation. Most surgeons prefer simple closure of the perforation with drainage of the peritoneum. Small-bowel resection is indicated for patients with multiple perforations.
Prevention
1. Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.
2. Drink only boiled or bottled water and eat well-cooked food.
3. Vaccines.
Signs and Symptoms
1. In the First Week :
- Temperature rises slowly (Stepladder pattern)
- Headache
- Abdominal pain
- Malaise
- Cough
- Relative bradycardia
- Widal test is negative in the first week.
2. In the Second Week :
- Fever ( around 104 °F)
- Delirium
- Bradycardia
- Hepatosplenomegaly
- Rose spots appear on the lower chest and abdomen in around a third of patients
- Abdominal pain
- Diarrhea
3. In the Third Week :
- Intestinal haemorrhage due to bleeding in congested Peyer's patches
- Intestinal perforation in the distal ileum
- Encephalitis
- Metastatic abscesses
4. In the Fourth Week :
- By the end of third week, the fever starts subsiding (defervescence). This carries on into the fourth and final week.
Exams and Tests
1. A complete blood count (CBC) will show a high number of white blood cells.
2. A blood culture during the first week of the fever can show S. typhi bacteria.
3. Other tests that can help diagnose this condition include:
- ELISA urine test to look for the bacteria that cause Typhoid fever
- Fluorescent antibody study to look for substances that are specific to Typhoid bacteria
- Platelet count (platelet count may be low)
- Stool culture
Treatment
1. Fluids and electrolytes may be given by IV (into a vein). Or you may be asked to drink uncontaminated water with electrolyte packets.
2. Antibiotics are given to kill the bacteria, the treatment of choice is a fluoroquinolone such as ciprofloxacin. Otherwise, a third-generation cephalosporin such as ceftriaxone or cefotaxime is the first choice. Cefixime is a suitable oral alternative.
3. When untreated, typhoid fever persists for three weeks to a month. Death occurs in between 10% and 30% of untreated cases. In some communities, however, case-fatality rates may reach as high as 47%.
4. Surgery : Surgery is usually indicated in cases of intestinal perforation. Most surgeons prefer simple closure of the perforation with drainage of the peritoneum. Small-bowel resection is indicated for patients with multiple perforations.
Prevention
1. Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.
2. Drink only boiled or bottled water and eat well-cooked food.
3. Vaccines.
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