Signs and Symptoms
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.
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
Typhoid Fever:
Caused by Salmonella Typhi.
Paratyphoid Fever:
Caused by Salmonella Para typhi A, B, or C, generally resulting in a milder illness.
Etiology
Causative Agent: Salmonella enterica serotype Typhi (S. Typhi).
Transmission: Fecal-oral route via contaminated food or water, person-to-person contact.
Pathogenesis
Entry: Bacteria are ingested, survive stomach acid, and reach the intestines.
Invasion: They penetrate the intestinal mucosa and are phagocytosed by macrophages.
Spread: Bacteria survive within macrophages, travel to lymphoid tissues, and disseminate via the bloodstream to various organs.
Systemic Infection: Results in widespread inflammation and systemic symptoms.
Treatment
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.
Supportive Care:
Hydration: Oral rehydration solutions or intravenous fluids.
Nutritional Support: Maintaining adequate nutrition during illness.
Rest: Ensuring the patient gets enough rest.
Prevention:
Vaccination: Typhoid vaccines (oral or injectable) are available and recommended for travelers to endemic areas.
Safe Drinking Water: Ensuring access to clean and safe water.
Sanitation: Proper disposal of sewage and maintaining clean living environments.
Hygiene Practices: Regular hand washing and safe food handling practices.