From the Guidelines
Typhoid disease is a bacterial infection caused by Salmonella Typhi that primarily spreads through contaminated food and water, affecting the intestinal tract and bloodstream, and causing symptoms like persistent high fever, headache, abdominal pain, and sometimes a rash of flat, rose-colored spots. This disease is characterized by insidious onset of sustained fever, headache, malaise, anorexia, relative bradycardia, constipation or diarrhea, and nonproductive cough, as described in the study by 1. The clinical presentation of typhoid fever can be non-specific, making it challenging to diagnose, especially in returned travelers, as noted in the study by 1.
Key Characteristics of Typhoid Disease
- Caused by Salmonella Typhi
- Spread through contaminated food and water
- Affects the intestinal tract and bloodstream
- Symptoms include persistent high fever, headache, abdominal pain, and sometimes a rash
- Can be life-threatening if untreated, potentially causing intestinal bleeding or perforation
Diagnosis and Treatment
The diagnosis of typhoid fever is typically made through blood cultures, which have the highest yield within a week of symptoms onset, as reported in the study by 1. Treatment typically involves antibiotics such as ciprofloxacin, azithromycin, or ceftriaxone, depending on antibiotic resistance patterns, as recommended in the study by 1. Patients should rest, stay hydrated, and take acetaminophen for fever.
Prevention
Prevention is crucial through improved sanitation, safe drinking water, proper handwashing, and vaccination (either oral Ty21a vaccine or injectable Vi polysaccharide vaccine), as noted in the study by 1. Typhoid vaccination is recommended as an adjunct to hand hygiene and the avoidance of high-risk foods and beverages, for travelers to areas where there is moderate to high risk for exposure to Salmonella enterica subspecies enterica serovar Typhi.
Complications and Carrier State
Typhoid can be life-threatening if untreated, potentially causing intestinal bleeding or perforation, so prompt medical attention is essential, as warned in the study by 1. The bacteria can persist in some recovered individuals who become asymptomatic carriers, continuing to spread the disease without showing symptoms themselves, as described in the study by 1.
From the Research
Definition of Typhoid Disease
- Typhoid disease, also known as typhoid fever, is a human-specific disease caused by the bacterium Salmonella enterica subspecies enterica serovar Typhi 2.
- It is transmitted through the ingestion of contaminated food or water 2, 3.
Symptoms and Diagnosis
- The disease is mostly diagnosed by blood culture 2.
- Symptoms of typhoid fever include febrile illness with bacteremia after initial entry through the gastrointestinal route 2.
- Other symptoms may include abdominal pain, diarrhea, chills, and headache 4.
- Complications can occur, including digestive complications, and can be life-threatening 2, 5.
Treatment and Prevention
- Treatment of typhoid fever should be guided by antimicrobial susceptibility testing whenever possible 6.
- Antibiotics such as ceftriaxone or ciprofloxacin are commonly used to treat typhoid fever 6, 4.
- Prevention measures include receiving typhoid vaccination before traveling to areas with endemic typhoid and adhering to safe food and water precautions 6.