Typhoid or Enteric fever is serious and common infection caused by
- The gram-negative bacilli Salmonella typhi and Para Salmonella typhi and
- Characterized by sustained fever, abdominal pain, and a rash.
- Water and food borne disease
- Contamination of food products and water supplies with infected fecal matter causes widespread infections.
- Flies can spread the infection directly from stool to foods.
The symptoms of typhoid fever start 7-14 days after consuming food or drinks contaminated
with the Salmonella typhi bacteria. Untreated typhoid runs a course having four classical
stages each lasting for about a week.
Fever with headache,
Relatively slow hearts beats and cough.
There may be abdominal pain and
Episodes of bleeding from the nose.
Into the second week of untreated infection, symptoms seen are:
Fever around 40°C (104°F) with relatively low pulse rate (Bradycardia).
Bloated, distended and painful Abdomen in the right lower quadrant.
Bowel sounds are loud and audible.
Minute 'rose-colored' skin rash over the lower chest and upper abdomen, occur in nearly 50% of cases and last for 3 to 5 days.
The person may appear to be in a delirious state, constantly muttering to himself or picking at the bed-sheets.
Diarrhoea may occur in this stage. Around 5 to 8 diarrheal stools, greenish, and looking like pea-soup are seen. However, constipation is more commonly seen.
Joint pains may be present.
The liver and spleen may seem enlarged.
The 3rd week of untreated typhoid can present with life-threatening emergencies:
Intestinal perforation - perforation of the walls of small intestine can be life-threatening.
Bleeding into the intestines
Spread of the infection to the brain via the blood causing inflammation of the brain.
Inflammation of the gall-bladder, heart muscles; infections in the bones, and formation of abscesses within other important internal organs.
Important laboratory investigations are: