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Typhoid Fever

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Typhoid fever also called enteric fever is common worldwide and is a life threatening and debilitating illness, transmitted by close contact or by ingestion of food or water contaminated with feces from an infected person usually presenting with high fever, headache, abdominal pain, and either constipation or diarrhea.

 

Causes:

  • Salmonella typhi causes typhoid fever it is a gram negative bacillus which is motile because of flagella spread by contaminated food, drink, or water
  • Can occur in Hotels and restaurants
  • Poor hygienic areas and contact with unhygienic persons who are infected
  • Contaminated drinking water and sanitation

Symptoms:

  • Severe headache
  • Fever, Chills, fatigue and weakness
  • Loss of Appetite
  • General discomfort, uneasiness, or ill feeling (malaise)
  • Rash (rose spots) appearing on the lower chest and abdomen
  • Pain abdomen
  • Constipation, then diarrhea sometimes with bloody stools

Tests and Diagnosis:

  • History of travel and food history
  • An elevated white blood cell count in blood
  • A blood culture during first week of the fever can show S. typhi bacteria
  • A stool culture
  • An ELISA or Widal test on urine may show Vi antigen specific for the bacteria
  • A platelet count will be decreased
  • A fluorescent antibody study shows specific Vi antigen

Treatment:

  • Hospitalization
  • Intravenous fluids and electrolytes may be given to treat dehydration
  • Antibiotics, such as Ampicillin, Chloramphenicol, trimethoprim-sulfamethoxazole, Amoxicillin and Ciprofloxacin
  • Third-generation cephalosporin such as Ceftriaxone or Cefotaxime or Cefixime is the first choice
  • Proper diet and oral fluids such as fruit juices and tender coconut
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