Typhoid Fever (cont.)
What are the symptoms of typhoid fever?
The incubation period is usually one to two weeks, and the duration of
the
illness is about four to six weeks. The patient experiences
- poor
appetite,
- headaches,
- generalized aches and pains,
- fever,
- lethargy, and
- diarrhea.
People with typhoid fever usually have a sustained fever as high as 103 to
104 degrees Fahrenheit (39 to 40 degrees Celsius).
Chest
congestion develops in many patients, and abdominal pain and
discomfort are
common. The fever becomes constant. Improvement occurs in the
third and
fourth week in those without complications. About 10% of
patients have
recurrent symptoms (relapse) after feeling better for one to
two weeks.
Relapses are actually more common in individuals treated with
antibiotics.
How is typhoid fever treated, and what is the prognosis?
Typhoid fever is treated with antibiotics which kill the Salmonella bacteria. Prior to the use of antibiotics, the fatality rate was 20%. Death occurred from overwhelming infection, pneumonia, intestinal bleeding, or intestinal perforation. With antibiotics and supportive care, mortality has been reduced to 1%-2%. With appropriate antibiotic therapy, there is usually improvement within
one to two days and recovery within seven to 10 days.
Several antibiotics are effective for the treatment of typhoid fever. Chloramphenicol was the original drug of choice for many years. Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics. The choice of antibiotics needs to be guided by identifying the geographic region where the organism was acquired and the results of cultures once available. (Certain strains from South America show a significant resistance to some antibiotics.) If relapses occur, patients are retreated with antibiotics.
The carrier state, which occurs in 3%-5% of those infected, can
be
treated with prolonged antibiotics. Often, removal of the
gallbladder, the
site of chronic infection, will cure the carrier state.
For those traveling to high-risk areas, vaccines are now
available.
- Typhoid fever is caused by Salmonellae typhi bacteria.
- Typhoid fever is contracted by the ingestion of
contaminated food or
water.
- Diagnosis of typhoid fever is made when the Salmonella
bacteria is
detected with a stool culture.
- Typhoid fever is treated with antibiotics.
- Typhoid fever symptoms are poor appetite, headaches, generalized
aches and pains, fever, and lethargy.
- Approximately 3%-5% of patients become carriers of the bacteria after the
acute
illness.
Last Editorial Review: 3/20/2008
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