Typhoid fever is one of the common febrile condition seen in day to day clinical practice

Causes

Bacteria called Salmonella typhi causes typhoid. Salmonella typhi is passed in the faeces and sometimes in the urine of infected people.

One can contract the infection if he/she eats food handled by someone with typhoid fever who has not washed carefully after using the toilet. One can also become infected by drinking water contaminated with the bacteria. Therefore, the bacteria that cause typhoid fever spread through contaminated food or water and occasionally through direct contact with someone who is infected.

Typhoid Carriers

Typhoid carriers are those people who continue to carry (In intestine and gallbladder) and shed Salmonella typhi in their faeces and/or urine without any symptoms of typhoid fever. These people are capable of infecting others.

Symptoms & Signs

Symptoms usually appear within 7-10 days after exposure to the bacteria and may last for 3-4 weeks.

1. Step ladder fever which becomes higher and higher each day anddrops on subsequent morning is typical of Typhoid fever.

2. Headache

3. Abdominal pain

4. Green pea soup type of diarrhoea or constipation

5. Dry cough

6. Enlarged spleen and liver

7. Delirium and disorientation from high fever and dehydration

8. Lassitude, weakness and tiredness

9. Rose spots rash on the body

Complications of Typhoid fever

• Perforation of intestine and intestinal bleeding.
• Rarely may lead to pneumonia,infection of heart, kidney, brain, CSF and meninges

Prevention

• Drink clean and filtered water
• Wash hands before having food
• Choose to have hot food
• Vaccine if situation demands like family members of infected person or travelling to endemic areas. Vaccine can be taken as injection form or ingested as capsule. Neither of vaccine is 100 percent effective.

Prevent infecting others

• Take complete course of antibiotics as prescribed by doctor
• Avoid handling food
• Wash hands often

Treatment

• Fever treated with paracetamol and fluid to manage dehydration (adequate oral or IV fluids)
• Appropriate antibiotics like Ciprofloxacin, Ofloxacin, Azithromycin or IV Ceftriaxone if you find resistance.
• Supplementing with adequate nutrition is also important