Typhoid FeverDr Ashwini Kalantri

Signs and Symptoms

4 stages

1. Fever, relative bradycardia, malaise, headache and cough. Epistaxis. Widal – nagative

2. Fever, bradycardia, delirium, Rose spots. Diarrhea – pea soup. Hepatosplenomegaly. Widal – positive.

3. Intestinal hemorrhage and perforation. Neuro-psychiatric symptoms. Encephalitis.

4. Typhoid state. Delirium. Fever falls.

Stages

1. Hyperplasia stage

2. Necrosis stage

3. Ulcerative stage

4. Healing stage

Salmonella typhi

rod shaped, flagellated, aerobic, Gram-negative bacterium

Transmission

Fecal-oral route

Poor hygiene and sanitation.

Flies and insects.

Asymptomatic carrier

Mary

Mallo

n a

.k.a. Ty

ph

oid

Mary

Diagnosis

History and examination

Blood, bone marrow and stool culture.

Widal test

Treatment

Rehydration

Quinolones, Ciprofloxacin, Cefixime

Resistant – Chloramphenicol

Not fatal with treatment.

10-30% death if left untreated.

Prevention

Epidemiology

16-33 million cases

200000+ deaths

Highest incidence – 5-19 year old

Distribution