Patients with typhoid fever may display high fever of 103 or 104 degrees Fahrenheit, weakness, abdominal pain, headache, and loss of appetite. These patients may also demonstrate problems with attention, mental confusion, hallucinations, and emotional instability. There may be a characteristic skin rash which physicians call rose spots. Physical examination may also show enlargement of the liver or spleen. A thorough history and physical examination is necessary in these cases (Centers for Disease Control, 2010).
The clinical signs and symptoms are the result of bacterial multiplication in the human body, and the microorganisms tend to reside in the bloodstream and intestinal tract. They may also travel to other parts of the human body such as lymph nodes, gallbladder, liver, and spleen.
Clinical Laboratory Evaluation
There is diagnostic benefit from the use of several laboratory tests. This includes enzyme-linked immunosorbent assay (ELISA) of the urine, complete blood count with platelets, and blood and stool cultures. Fluorescent antibody is useful as well. The cultures will serve to confirm the presence of Salmonella typhi, and fluorescent antibody and ELISA will also help to specifically identify that microbe as the reason for the illness.
Medical Therapy
Two to four weeks of medical therapy are necessary. The patient will benefit from intravenous fluids and antibiotics. Whenever they consume water, it should not be contaminated, and it is advisable to include electrolyte packets with it. Prior to departure from their home country, individuals who plan to visit areas endemic for typhoid fever should speak with their physician about whether they should carry electrolyte packets with them.
Resistance to antibiotics has occurred over the decades, and the current agents in use are ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin. Though relapses of typhoid fever are common, antibiotic therapy usually leads to recovery in a matter of days. Those who do not receive antibiotics may continue to experience fever for many weeks or months, and they are at risk for complications of the disease.
Complications of typhoid fever may include gastrointestinal bleeding, intestinal perforation, kidney failure, and peritonitis.
Of those who do not obtain medical treatment, a fifth will die from the condition.
Sources
- Centers for Disease Control. (2010). Typhoid fever. Retrieved February 18, 2012.
- New York State Department of Health. (2011). Typhoid fever. Retrieved February 18, 2012.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.
Michael Koger - Dr. Koger obtained his medical education at Meharry Medical College and specialized in Internal Medicine.
Join the Conversation