Enteric Fever

Typhoid

Pathology:                   Salmonella typhi, salmonella paratyphiA, B and C, as well as some non-typhoidal salmonella infections, have an incubation period of 10-20 days.

Aetiology:                     Typhoid is transmitted via faeco-oral transmission via food or water.

Symptoms:                  

• 1^st week: Fever, headache, dry cough, abdominal pain, and constipation.
• 2^nd week: High fever, delirium, and foul 'pea soup' diarrhoea.
• 3^rd week: Death or slow recovery.

Signs:                              Rosespots (between navel and nipples).

Investigations:          Bloods: FBC, U&E

Microbiology: Stoolculture

Treatment:                  Medical: Antibiotics are prescribed based on local sensitivities and may be supplemented with steroids for severe toxaemia.

Complications:          Intestinal haemorrhage, pneumonia, bowel perforation, encephalitis, and chronic carriage are potential complications.

Prognosis:                    Generally excellent with treatment; however, death may occur in up to 20% of cases with untreated typhoid. Additionally, long-term neuropsychiatric symptoms have been linked to typhoid fever.

Figure 9.7 Rose spotsin patient with typhoid

‍