From the Research
Yes, a patient can present with high fecal calprotectin levels after a typhoid infection. Typhoid fever, caused by Salmonella Typhi bacteria, triggers intestinal inflammation that can persist for weeks to months after the acute infection resolves. This ongoing inflammation in the gastrointestinal tract can lead to elevated fecal calprotectin, which is a protein released by neutrophils during inflammatory processes in the intestines. The elevation may remain detectable during the recovery phase as the gut heals from the infection-induced damage.
Key Points to Consider
- Clinicians should be aware that post-infectious elevated calprotectin levels typically normalize gradually over time without specific treatment, though this may take several weeks to months depending on the severity of the initial infection.
- If levels remain persistently high beyond the expected recovery period, further investigation may be warranted to rule out other inflammatory conditions or complications.
- Monitoring calprotectin levels can help assess the resolution of intestinal inflammation following typhoid infection, as seen in studies such as 1, which highlights the utility of fecal calprotectin in identifying inflammatory bowel disease (IBD) and potentially other inflammatory conditions.
- The clinical spectrum of patients with high fecal calprotectin levels can include symptoms such as diarrhea, abdominal cramps, and weight loss, as noted in 1, which may guide the approach to managing patients post-typhoid infection.
Evidence and Recommendations
The most recent and highest quality study relevant to the question of fecal calprotectin levels after typhoid infection is 1, published in 2020. This study, while focused on the clinical spectrum of patients with high fecal calprotectin levels, supports the use of fecal calprotectin as a biomarker for intestinal inflammation. Given the lack of direct evidence linking typhoid infection to fecal calprotectin levels in the provided studies, the recommendation is based on the understanding of the pathophysiology of typhoid fever and the role of fecal calprotectin in detecting intestinal inflammation. Therefore, it is reasonable to monitor fecal calprotectin levels in patients after a typhoid infection to assess the resolution of intestinal inflammation, keeping in mind the potential for elevated levels to persist for some time after the infection has resolved, as inferred from the general principles of infectious diseases and inflammation.