What are the symptoms of typhoid fever?

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Symptoms of Typhoid Fever

General Symptoms of Typhoid Fever

Typhoid fever, caused by the bacterium Salmonella enterica serovar Typhi, is a systemic infection that presents with a variety of symptoms. The most common and consistent symptom is a prolonged fever, which is often described as having a "step-ladder" pattern, where the fever gradually increases over time . Other general symptoms include headache, nausea, loss of appetite, and malaise .

Gastrointestinal Symptoms

Gastrointestinal manifestations are a significant aspect of typhoid fever. Patients often experience abdominal pain, which can be diffuse and severe . Diarrhea and constipation are also common, though the prevalence of each can vary . In severe cases, gastrointestinal complications such as intestinal bleeding, perforation, cholecystitis, and cholangitis may occur .

Neurologic Symptoms

In some cases, typhoid fever can present with neurologic symptoms. These can include ataxia, parkinsonism, tremors, and hyperreflexia. During an outbreak in Malawi-Mozambique, a significant proportion of patients exhibited neurologic findings such as spasticity and sustained ankle clonus. Brain MRI scans of affected individuals showed cerebral atrophy, although other abnormalities were not commonly observed.

Specific Clinical Signs

Certain clinical signs are considered classic for typhoid fever, although they may not always be present. These include rose spots, which are small, rose-colored rashes that appear on the abdomen and chest, and relative bradycardia, where the heart rate is slower than expected for the level of fever . Hepatosplenomegaly, or the enlargement of the liver and spleen, is another notable sign.

Severe Complications

Severe complications of typhoid fever can be life-threatening and include encephalopathy, cardiovascular collapse, acute renal failure, pneumonitis, hepatic failure, severe anemia, and haematophagocytic syndrome. These complications are more likely to occur in patients who have been ill for an extended period before receiving treatment.

Conclusion

Typhoid fever presents with a wide range of symptoms, from general signs like fever and headache to severe gastrointestinal and neurologic complications. Recognizing these symptoms early and confirming the diagnosis through appropriate tests is crucial for effective treatment and prevention of transmission.