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Can Typhoid Fever Relapse Post Recovery?

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Posted on Thu, 30 Jun 2016
Question: My mom had tyophide couple of months back but now again she is hsowing syptoms mild fever and weakness. Our local doctor at village said its tyophide and suggested to wait for 5/6 days to check if it gets well. She is 55+ and has been taking meds for time to time for different reasons. She is alergic to heavy medications and often develope alsers in mouth after having heavy painkillers or antibiotics. Recently she took painkills for toothpain and after that syptons for tyoohide observed. Please suggest if we need to take any tests for lever or to ensure tyoohide recovery. Local doctor suggested to go for vaccine if it wont recover in couple of weeks and mild symtoms being observed again and again.
doctor
Answered by Dr. Tushar Kanti Biswas (12 hours later)
Brief Answer:
Typhoid fever -probably relapse

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.



Up to 10% of patients with Typhoid fever develop mild relapse, usually within 2–3
weeks of fever resolution and in association with the same strain type
and susceptibility profile.
Relapse is managed with a similar (10-14 days) or abbreviated course (5-7 days) of the same therapy (antibiotics) used in the initial episode.

Many patients excrete S. typhi in their stools or urine for some days after starting antibiotic treatment. Convalescent carriers excrete for periods up to 3 months.Faecal carriage is more frequent in individuals with gallbladder disease and is most common in women over 40.
Your mom might be a chronic carrier.
Do an Ultra-sonography of abdomen to exclude gall bladder disease.

Two typhoid vaccines are commercially available: (1) Ty21a, an
oral live attenuated S. typhi vaccine (given on days 1, 3, 5, and 7, with
a booster every 5 years); and (2) Vi CPS, a parenteral vaccine consisting
of purified Vi polysaccharide from the bacterial capsule (given in
a single dose, with a booster every 2 years).
However in endemic areas( like most of the sates in XXXXXXX ), the cumulative efficacy is 48% for Ty21a at 2.5–3.5 years and 55% for Vi CPS at 3 years.
Efficacy rates of Typhoid Vaccine to prevent Typhoid fever may be even lower in certain endemic areas.




Regards

Dr. T.K. Biswas M.D. XXXXXXX
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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Can Typhoid Fever Relapse Post Recovery?

Brief Answer: Typhoid fever -probably relapse Detailed Answer: Hi, Thank you for your query. I can understand your concerns. Up to 10% of patients with Typhoid fever develop mild relapse, usually within 2–3 weeks of fever resolution and in association with the same strain type and susceptibility profile. Relapse is managed with a similar (10-14 days) or abbreviated course (5-7 days) of the same therapy (antibiotics) used in the initial episode. Many patients excrete S. typhi in their stools or urine for some days after starting antibiotic treatment. Convalescent carriers excrete for periods up to 3 months.Faecal carriage is more frequent in individuals with gallbladder disease and is most common in women over 40. Your mom might be a chronic carrier. Do an Ultra-sonography of abdomen to exclude gall bladder disease. Two typhoid vaccines are commercially available: (1) Ty21a, an oral live attenuated S. typhi vaccine (given on days 1, 3, 5, and 7, with a booster every 5 years); and (2) Vi CPS, a parenteral vaccine consisting of purified Vi polysaccharide from the bacterial capsule (given in a single dose, with a booster every 2 years). However in endemic areas( like most of the sates in XXXXXXX ), the cumulative efficacy is 48% for Ty21a at 2.5–3.5 years and 55% for Vi CPS at 3 years. Efficacy rates of Typhoid Vaccine to prevent Typhoid fever may be even lower in certain endemic areas. Regards Dr. T.K. Biswas M.D. XXXXXXX