*FOR YOUR

INFORMATION*
name S. typhi

The
is
derived from
the ancient Greek typhos,
an
ethereal smoke or cloud
that was
believed to cause disease

DEFINITION
Severe

infection
caused by a virulent
bacteria, a bacillus,
Salmonella typhi

From typhus + -oid; so

called because the

symptoms
resemble
those of typhus
Hallmark

is
persistently high fever

SYNONYM/S
Enteric Fever
Typhoid

MORPHOLOGICAL DESCRIPTION
Salmonella typhi are

rod
shaped, gram negative
bacteria

It

is an active mobile
bacteria, from the family
enterobacteriaceae with
a
diameter
of
0.7-1.5
microns and a length of 2.5
microns.

Facultative

anaerobes;
Chemoorganotrophs that do

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MODE OF TRANSMISSION
Fecal-Oral Route

MODE OF TRANSMISSION
Fecal-oral transmission route
S. typhi must be ingested to cause disease.

Transmission often occurs when a person in

the carrier state does not wash hands
thoroughly (or not at all) after
defecation and serves food to others.

Open sewage is accessible to flies, the

insects land on the sewage, pick up the

bacteria, and then contaminate food to be
eaten by humans.

Salmonella typhi is passed in the feces and

SIGNS AND SYMPTOMS

TYPHOID FEVER

SIGNS AND SYMPTOMS

Increasingly high fever up to 40.5 C

(usually rises in the afternoon)

Constipation (at first), then diarrhea

(green stools) on the 2nd week

Loss of appetite
Extreme fatigue
Headache
Muscle aches and joint pain
Abdominal pain on the right lower

quadrant

Rash across the abdomen (known as rose

DIAGNOSTIC/LAB TESTS
The diagnosis of typhoid fever is

confirmed by a patients blood

culture, stool, urine, and bone
marrow.
It may also be grown in a laboratory

for
identification
microscope.

under

Blood cultures are usually the

most

accurate

method

of

PERIOD OF
COMMUNICABILITY
Communicable as long as typhoid

Salmonella typhi is present in

excreta.
Some patients become

permanent carriers.

INCUBATION PERIOD
This period of time, during which the

bacteria are multiplying within the

phagocytes, is the 10 to 14-day
incubation period of typhoid fever.
When huge numbers of bacteria fill an

individual phagocyte, they spill out of the

cell and into the bloodstream, where
their
presence
begins
to
cause
symptoms.

PROGNOSIS
Before

effective antibiotics were

discovered, about 12% of typhoid
fever patients died of infection.

Typhoid

fever may progress to

delirium,
obtundation,
intestinal
hemorrhage, bowel perforation, and
death within one month of onset.

PROGNOSIS
Survivors may be left with long-term or

permanent neuropsychiatric
complications including stupor or coma
Mortality rate is highest in the very

young, the very old, and those

suffering from malnutrition
Now, however, only fewer than 1% of

patients who receive prompt antibiotic

treatment will die.

TREATMENT
Chloramphenicol original drug of choice
Ciprofloxacin for nonpregnant patients
Ceftriaxone for pregnant patients
Ampicillin
Amoxicillin
Rifampin
Trimethoprim-sufamethoxazole

PREVENTIVE/CONTROL
MEASURES
Hygienic sewage disposal systems in a

community
Proper personal hygiene
Immunizations

are
available
for
travelers who expect to visit countries
where S. typhi is a known public health
problem. Although the most commonly
reported side effects are flu-like muscle
cramps
and
abdominal
pain
(antibioterrorism agents)