Typhoid fever Health Article

Definition

Typhoid fever is a bacterial infection characterized by diarrhea, systemic disease, and a rash -- most commonly caused by the bacteria Salmonella typhi (S. typhi).

Alternative Names

Enteric fever

Causes, incidence, and risk factors

The bacteria that causes typhoid fever -- S. typhi -- spreads through contaminated food, drink, or water. If you eat or drink something that is contaminated, the bacteria enters your body, and goes into your intestines, and then into your bloodstream, where it can travel to your lymph nodes, gallbladder, liver, spleen, and other parts of the body.

A few people can become carriers of S. typhi and continue to release the bacteria in their stools for years, spreading the disease.

Typhoid fever is common in developing countries, but fewer than 400 cases are reported in the U.S. each year. Most cases in the U.S. are brought in from overseas.

Symptoms

Early symptoms include fever, general ill-feeling, and abdominal pain. A high (over 103 degrees) fever and severe diarrhea occur as the disease gets worse.

Some people with typhoid fever develop a rash called "rose spots," which are small red spots on the belly and chest.

Other symptoms that occur include:

• Abdominal tenderness
• Agitation
• Bloody stools
• Chills
• Confusion
• Difficulty paying attention (attention deficit)
• Delirium
• Fluctuating mood
• Hallucinations
• Nosebleeds
• Severe fatigue
• Slow, sluggish, lethargic feeling
• Weakness

Signs and tests

A complete blood count (CBC) will show a high number of white blood cells.

A blood culture during first week of the fever can show S. typhi bacteria

Other tests that can help diagnose this condition include:

• Stool culture
• ELISA urine test to look for the bacteria that causes Typhoid fever
• Platelet count (platelet count will be low)
• Fluorescent antibody study to look for substances specific to Typhoid bacteria

Treatment

Fluids and electrolytes may be given through a vein (intravenously). Appropriate antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic.