|Other encyclopedia topics:||A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9|
|Contents of this page:|
Alternative Names Return to topEnteric fever
Definition Return to top
Typhoid fever is a bacterial infection characterized by diarrhea, systemic disease, and a rash -- most commonly caused by the bacteria Salmonella typhi.
Causes Return to top
S. typhi are spread by contaminated food, drink, or water. Following ingestion, the bacteria spread from the intestine via the bloodstream to the intestinal lymph nodes, liver, and spleen via the blood where they multiply.
Salmonella may directly infect the gallbladder through the hepatic duct or spread to other areas of the body through the bloodstream.
Early symptoms are generalized and include fever, malaise and abdominal pain. As the disease progresses, the fever becomes higher (greater than 103 degrees Fahrenheit), and diarrhea becomes prominent. Weakness, profound fatigue, delirium, and an acutely ill appearance develop.
A rash, characteristic only of typhoid and called "rose spots," appears in some cases of typhoid. Rose spots are small (1/4 inch) red spots that appear most often on the abdomen and chest. Typically, children have milder disease and fewer complications than adults.
A few people can become carriers of S. typhi and continue to shed the bacteria in their feces for years, spreading the disease, as in the case of "Typhoid Mary" in New York over 100 years ago.
Although typhoid fever is common in developing countries, less than 400 cases are reported in the U.S. each year, most brought in from abroad.
Symptoms Return to top
Exams and Tests Return to top
Treatment Return to top
Intravenous fluids and electrolytes may be given. Appropriate antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so the choice of antibiotics should be a careful one.
Outlook (Prognosis) Return to top
The illness usually resolves in 2 to 4 weeks with treatment. The outcome is likely to be good with early treatment, but becomes poor if complications develop. Cases in children are milder, and are more debilitating in the elderly.
Relapse may occur if the treatment has not fully eradicated the infection.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
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.
Prevention Return to top
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.Update Date: 6/20/2007 Updated by: Arnold L. Lentnek, MD, Division of Infectious Disease, Kennestone Hospital, Marietta, GA. Review provided by VeriMed Healthcare Network.