Typhoid fever
What is typhoid fever?
Typhoid fever, otherwise known as enteric fever, is a bacterial infection caused by Salmonella typhi (S. typhi). It is transmitted through food or water contaminated with infectious feces, causing severe diarrhea and a rash. It is more common in developing countries, in areas of poor sanitation.
Causes
Typhoid fever is caused by Salmonella typhi bacteria. They enter the body when contaminated food or water is ingested. They then travel to the bloodstream where they spread throughout the body. Sometimes the bacteria manage to enter the gall bladder, in which case people become carriers. Carriers do not have symptoms, but they continue to expel the bacteria in their feces, which can then infect others if water and food supplies become contaminated.
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Gall bladder
A small organ attached to the liver that stores bile until it is released into the small intestine, to aid the digestion of food.
Risk factors
Risk factors for typhoid fever include:
- Travel to developing countries with poor sanitation;
- Ingesting raw and undercooked food, or untreated water that may be contaminated with S. typhi;
- Not being vaccinated against S. typhi, and;
- Poor personal hygiene.
Signs and symptoms
In the early stages of infection, possible symptoms include:
- Diarrhea;
- Fever;
- Abdominal pain, and;
- A rash of small red spots on the abdomen and chest.
Other potential symptoms include:
- Abdominal discomfort;
- Bloody stools;
- Chills;
- Confusion;
- Weakness and fatigue, and;
- Nosebleeds.
Typhoid fever can cause a rash of red spots on the abdomen and chest.
Methods for diagnosis
A doctor may suspect typhoid fever based on your signs and symptoms. To confirm the diagnosis, blood, urine and stool samples are also tested for the presence of S. typhi bacteria.
Types of treatment
Typhoid fever may initially be treated in a hospital, particularly if you have severe symptoms. Types of treatments include:
Intravenous fluids
You can quickly become dehydrated as a result of diarrhea. Replacing fluids helps to maintain your hydration and electrolyte levels.
Antibiotics
Antibiotics, such as ciprofloxacin and ceftriaxone, may be used to clear the infection. With rising rates of antibiotic resistance, more broad-spectrum antibiotics are required to successfully treat the infection.
Self care
You will generally be discharged from the hospital once you are improving. It is likely that you will be given oral antibiotics to continue at home. In addition, the following is recommended:
- Regular washing of your hands with soap, especially after visiting the toilet, to prevent infecting others or re-infecting yourself;
- Keep well hydrated, preferably with water and oral rehydration drinks;
- Avoid spicy or greasy foods and try to eat mainly bland foods, such as dry crackers, until your symptoms settle, and;
- Unless prescribed by your doctor, avoid taking anti-diarrhea or anti-nausea medications, which can prolong infections and delay recovery.
Potential complications
Intestinal hemorrhage and perforation
The most common complication of typhoid fever is bleeding in the gastrointestinal tract (intestinal hemorrhage), as the infection damages the lining of the intestine. This can show up as bloody feces.
Other complications that can occur as a result of severe dehydration, or bacteria spreading throughout body, include:
- Kidney failure (although this is a rare complication);
- Inflammation of the abdominal wall lining;
- Inflammation of the heart muscle, and;
- Inflammation of the lung/s.
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Gastrointestinal tract
The membrane-lined series of organs extending from the mouth to the anus through which food passes during digestion.
Prognosis
Symptoms of typhoid fever usually subside within 2-4 weeks of starting a treatment. If the infection is treated early, the prognosis is good but, left untreated, the prognosis can be poor due to development of the serious complications described earlier. Symptoms may also return after treatment if the infection has not been completely cleared from the body.
Prevention
You can reduce your risk of developing typhoid fever by being vaccinated with a typhoid vaccine before your trip and by avoiding untreated water and raw foods that may have been exposed to untreated water supplies. Even with a vaccination, care should be taken with following food safety while travelling as a vaccine may not provide full protection to all people.
References
- Jong E. Netters Infectious Diseases.
- Typhoid fever - National Library of Medicine - PubMed Health. Accessed 16 July 2014 from link here
- Typhoid rhabdomyolysis with acute renal failure and acute pancreatitis: a case report and review of the literature. Accessed 16 July 2014 from link here
10 Most frequently asked questions (FAQs)
Typhoid fever, otherwise known as enteric fever, is an infection caused by Salmonella typhi bacteria. It is transmitted through contaminated food or water and can cause severe diarrhea and a rash. What are the symptoms of typhoid fever? In the early stages of infection, possible symptoms include diarrhea, fever, abdominal pain, and a rash of small red spots on the abdomen and chest. Other potential symptoms include bloody stools, chills, weakness and fatigue, and nosebleeds. What causes typhoid fever? Typhoid fever is caused by Salmonella typhi bacteria. It enters the body by ingestion of contaminated food or water and then travels to the bloodstream where it spreads throughout the body. How is typhoid fever diagnosed? A doctor may suspect typhoid fever based on your signs and symptoms. To confirm the diagnosis, blood, urine and stool samples are also tested for the presence of S. typhi bacteria. How is typhoid fever treated? Typhoid fever may initially be treated in a hospital, particularly if you have severe symptoms. Types of treatments include intravenous fluids, to maintain your hydration and electrolyte levels, and antibiotics. Once you are discharged from the hospital, self-care treatment includes maintaining good personal hygiene, keeping well hydrated, avoiding spicy or greasy foods, and avoiding taking anti-diarrhea or anti-nausea medications, unless your doctor advises you to do so. Is typhoid fever contagious? Typhoid fever is contagious. The Salmonella bacteria that cause typhoid fever can infect others through unsanitary contamination of water sources with infected human feces. Can typhoid fever be prevented? You can reduce your risk of developing typhoid fever by being vaccinated with a typhoid vaccine before travelling to areas where the infection is common. Avoiding untreated water sources and raw foods that may have been exposed to contaminated water may also reduce your risk of infection. Even with a vaccination, care should be taken with following food safety while travelling as a vaccine may not provide full protection to all people. Will typhoid fever keep coming back? You can still pass on typhoid fever to others even after you no longer have symptoms. It is important to finish your course of antibiotics as prescribed by your doctor and not to prepare food for other people until you have been given the all-clear. Is typhoid fever serious? Typhoid fever is a serious condition. The most common complication of typhoid fever is bleeding in the gastrointestinal tract, as the infection damages the lining of the intestine. Other complications that can occur as a result of the severe dehydration, or bacteria spreading throughout body, include: kidney failure (although this is a rare complication); inflammation of the abdominal wall lining; inflammation of the heart muscle, and; inflammation of the lung/s.
Related topics
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