Typhoid fever

URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/001332.htm

Typhoid fever is a bacterial infection characterized by diarrheadiarrhea, systemicsystemic

disease, and a rashrash -- most commonly caused by the bacteria Salmonella typhi (S. typhi).

Causes

Causes

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.

Symptoms

Symptoms

Early symptoms include feverfever, general ill-feeling, and abdominal painabdominal pain. A
high (over 103 degrees) fever and severe diarrhea occur as the disease gets worse.

Some people with typhoid fever develop a rash called "rose spots," which are small red spots on
the belly and chest.

Other symptoms that occur include:

• Abdominal tendernessAbdominal tenderness

• AgitationAgitation
• Bloody stoolsBloody stools
• Chills
• ConfusionConfusion
• Difficulty paying attention (attention deficit)
• DeliriumDelirium
• Fluctuating mood
• Hallucinations
• Nosebleeds
• Severe fatigue
 • Slow, sluggish, lethargiclethargic feeling
• Weakness

Exams and Tests

Exams and Tests

A complete blood count (CBC) will show a high number of white blood cells.

A blood cultureblood culture during first week of the fever can show S. typhi bacteria

Other tests that can help diagnose this condition include:

• Stool cultureStool culture

• ELISAELISA urine test to look for the bacteria that causes Typhoid fever
• Platelet countPlatelet count (platelet count will be low)
• Fluorescent antibodyantibody study to look for substances specific to Typhoid bacteria

Treatment

Treatment

Fluids and electrolyteselectrolytes 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.

Outlook (Prognosis)

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

Possible Complications

• Intestinal hemorrhage (severe GI bleedingGI bleeding)

• Intestinal perforation
• Kidney failureKidney failure
• PeritonitisPeritonitis

When to Contact a Medical Professional

When to Contact a Medical Professional

Call your health care provider if you have had any known exposure to typhoid fever or if you
have been in an endemicendemic 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 outputdecreased urine output, or other new symptoms develop.

Prevention

Prevention

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.

Alternative Names

Alternative Names

Enteric fever