Typhoid Fever

• Typhoid fever is a systemic bacterial infection caused by Salmonella enterica serotype Typhi (commonly called Salmonella typhi).
• It primarily affects the gastrointestinal system and can lead to severe complications if untreated.

Signs and Symptoms

1. Early Stage:

   • Fever: Starts low and increases daily.
   • Weakness: General feeling of malaise.
   • Abdominal Pain: Discomfort in the abdominal area.
   • Headache: Persistent and severe.
   • Diarrhea or Constipation: Alternating bowel habits.
   • Dry Cough: Non-productive cough.

2. Later Stage:

   • High Fever: Peaks at around 104°F (40°C).
   • Rash (Rose Spots): Small red spots, usually on the abdomen and chest.
   • Severe Abdominal Pain: Intense pain and tenderness.
   • Swollen Abdomen: Due to inflamed intestines.
   • Severe Fatigue: Profound weakness and lethargy.
   • Confusion or Delirium: Mental disturbances, sometimes termed “typhoid state.”

Types of Typhoid Fever

1. Typhoid Fever:

   • Caused by Salmonella Typhi.

2. Paratyphoid Fever:

   • Caused by Salmonella Para typhi A, B, or C, generally resulting in a milder illness.

Etiology

1. Causative Agent: Salmonella enterica serotype Typhi (S. Typhi).
2. Transmission: Fecal-oral route via contaminated food or water, person-to-person contact.

Pathogenesis

1. Entry: Bacteria are ingested, survive stomach acid, and reach the intestines.
2. Invasion: They penetrate the intestinal mucosa and are phagocytosed by macrophages.
3. Spread: Bacteria survive within macrophages, travel to lymphoid tissues, and disseminate via the bloodstream to various organs.
4. Systemic Infection: Results in widespread inflammation and systemic symptoms.

Treatment

1. Antibiotics:

   • Ciprofloxacin: Commonly used for adults.
   • Ceftriaxone: Effective for severe cases or drug-resistant strains.
   • Azithromycin: Used in cases of resistance to other antibiotics.
   • Ampicillin/Chloramphenicol: Historically used, now less common due to resistance.

2. Supportive Care:

   • Hydration: Oral rehydration solutions or intravenous fluids.
   • Nutritional Support: Maintaining adequate nutrition during illness.
   • Rest: Ensuring the patient gets enough rest.

Prevention:

1. Vaccination: Typhoid vaccines (oral or injectable) are available and recommended for travelers to endemic areas.
2. Safe Drinking Water: Ensuring access to clean and safe water.
3. Sanitation: Proper disposal of sewage and maintaining clean living environments.
4. Hygiene Practices: Regular hand washing and safe food handling practices.

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