Typhoid fever (patient information)

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 * Associate Editor(s)-in-Chief: Samuel A. Hom

Overview
Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi.

What are the symptoms of Typhoid fever?

 * Abdominal tenderness
 * Agitation
 * Bloody stools
 * Chills
 * Confusion
 * Difficulty paying attention (attention deficit)
 * Delirium
 * Fluctuating mood
 * Hallucinations
 * Nosebleeds
 * Severe fatigue
 * Slow, sluggish, lethargic feeling
 * Weakness

What causes Typhoid fever?
The bacteria that causes typhoid fever -- S. typhi -- spreads through contaminated food, drink, or water. If you eat or drink something that is contaminated, the bacteria enters your body, and goes into your intestines, and then into your bloodstream, where it can travel to your lymph nodes, gallbladder, liver, spleen, and other parts of the body. A few people can become carriers of S. typhi and continue to release the bacteria in their stools for years, spreading the disease. Typhoid fever is common in developing countries, but fewer than 400 cases are reported in the U.S. each year. Most cases in the U.S. are brought in from overseas.

Who is at highest risk?
Anyone who has been in contact with Salmonella Tyhpi bacteria.

When to seek urgent medical care?
Call your health care provider if you have had any known exposure to typhoid fever or if you have been in an endemic area and symptoms of typhoid fever develop. Also call your health care provider if you have had typhoid fever and relapse occurs or if severe abdominal pain, decreased urine output, or other new symptoms develop.

Diagnosis
When you have tested positive for S. Typhi in either a stool culture, ELISA or a Platelet count test facilitated by you're doctor.

Treatment options
Fluids and electrolytes may be given through a vein (intravenously). Appropriate antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic. Three commonly prescribed antibiotics are ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin. Persons given antibiotics usually begin to feel better within 2 to 3 days, and deaths rarely occur. However, persons who do not get treatment may continue to have fever for weeks or months, and as many as 20% may die from complications of the infection.

Where to find medical care for Typhoid fever?
Directions to Hospitals Treating Typhoid fever

What to expect (Outlook/Prognosis)?
Symptoms usually improve in 2 to 4 weeks with treatment. The outcome is likely to be good with early treatment, but becomes poor if complications develop. Symptoms may return if the treatment has not completely cured the infection.

Possible complications

 * Intestinal hemorrhage (severe GI bleeding)
 * Intestinal perforation
 * Kidney failure
 * Peritonitis

Prevention of Typhoid fever
Vaccines are recommended for travel outside of the U.S., Canada, northern Europe, Australia, and New Zealand, and during epidemic outbreaks. Immunization is not always completely effective and at-risk travelers should drink only boiled or bottled water and eat well cooked food. Experimentation with an oral live attenuated typhoid vaccine is now underway and appears promising. Adequate water treatment, waste disposal, and protection of food supply from contamination are important public health measures. Carriers of typhoid must not be allowed to work as food handlers.

Diseases with similar symptoms

 * Paratyphoid fever
 * Parenteric Fever
 * Gastroenteritis
 * Typhomalarial fever