Typhoid Fever

What are the symptoms of typhoid fever?

The incubation period is usually one to two weeks, and the duration of the illness is about four to six weeks. The patient experiences

• poor appetite
• headaches
• generalized aches and pains
• fever
• lethargy
• diarrhea

People with typhoid fever usually have a sustained fever as high as 103 to 104 degrees Fahrenheit (39 to 40 degrees Celsius).

Chest congestion develops in many patients, and abdominal pain and discomfort are common. The fever becomes constant. Improvement occurs in the third and fourth week in those without complications. About 10% of patients have recurrent symptoms (relapse) after feeling better for one to two weeks. Relapses are actually more common in individuals treated with antibiotics.

How is typhoid fever treated, and what is the prognosis?

Typhoid fever is treated with antibiotics which kill the Salmonella bacteria. Prior to the use of antibiotics, the fatality rate was 20%. Death occurred from overwhelming infection, pneumonia, intestinal bleeding, or intestinal perforation. With antibiotics and supportive care, mortality has been reduced to 1%-2%. With appropriate antibiotic therapy, there is usually improvement within one to two days and recovery within seven to 10 days.

Several antibiotics are effective for the treatment of typhoid fever. Chloramphenicol was the original drug of choice for many years. Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics. The choice of antibiotics needs to be guided by identifying the geographic region where the organism was acquired and the results of cultures once available. (Certain strains from South America show a significant resistance to some antibiotics.) If relapses occur, patients are retreated with antibiotics.

The carrier state, which occurs in 3%-5% of those infected, can be treated with prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, will cure the carrier state.

For those traveling to high-risk areas, vaccines are now available.

Typhoid Fever At A Glance

• Typhoid fever is caused by Salmonellae typhi bacteria.
• Typhoid fever is contracted by the ingestion of contaminated food or water.
• Diagnosis of typhoid fever is made when the Salmonella bacteria is detected with a stool culture.
• Typhoid fever is treated with antibiotics.
• Typhoid fever symptoms are poor appetite, headaches, generalized aches and pains, fever, and lethargy.
• Approximately 3%-5% of patients become carriers of the bacteria after the acute illness.