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 Dhengare2021Bano-Zaidi2018. Other general symptoms include headache, nausea, loss of appetite, and malaise Rasheed2019Dhengare2021.

Gastrointestinal Symptoms

Gastrointestinal manifestations are a significant aspect of typhoid fever. Patients often experience abdominal pain, which can be diffuse and severe Crum2003Hoffner2000. Diarrhea and constipation are also common, though the prevalence of each can vary Rasheed2019Rathi2022. In severe cases, gastrointestinal complications such as intestinal bleeding, perforation, cholecystitis, and cholangitis may occur Crum2003Bano-Zaidi2018.

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 Crum2003Hoffner2000. 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.

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Most relevant research papers on this topic

Extensively drug-resistant typhoid fever in Pakistan.

Drug-resistant typhoid fever is a significant public health issue in Pakistan, with a mortality rate of 5% in the country and a potential for onward transmission to others.

Rigorous Journal

2019·

73citations

·Muhammad Kamran Rasheed et al.

The Lancet. Infectious diseases·

DOI

Current trends in typhoid fever

Typhoid fever is a global health issue with multidrug resistance, empiric treatment is fluoroquinolone, and prevention involves good sanitation and food handling practices.

2003·

63citations

·N. Crum

Current Gastroenterology Reports·

DOI

Clinical Profile of Typhoid Fever in Children

Typhoid fever in children presents with nonspecific symptoms, and diagnosis is crucial for treatment and prevention of transmission.

Cross-Sectional Study

2022·

1citation

·S. Rathi et al.

International Journal of Medical and Biomedical Studies·

DOI

Emergency department presentations of typhoid fever.

Typhoid fever may present to emergency departments in the US, and it should be considered in the differential diagnosis for febrile patients from Latin America or those with a history of recent travel to endemic countries.

2000·

38citations

·R. J. Hoffner et al.

The Journal of emergency medicine·

DOI

Case Report of Typhoid Fever (Salmonella typhi)

Good sanitation, improved water supply, and sewage waste management, along with effective typhoid vaccinations, can help prevent typhoid fever.

Case Report

2021·

3citations

·Archana Dhengare et al.

Journal of Pharmaceutical Research International·

DOI

Typhoid fever outbreak with severe complications in Yucatan, Mexico.

A sudden increase in typhoid fever cases in Yucatan, Mexico, in 2017, led to 37 severe complications, including gastrointestinal bleeding, intestinal perforation, and encephalopathy, with three deaths.

Rigorous Journal

2018·

15citations

·Mussaret Bano-Zaidi et al.

The Lancet. Global health·

DOI

Neurologic Manifestations Associated with an Outbreak of Typhoid Fever, Malawi - Mozambique, 2009: An Epidemiologic Investigation

Neurologic signs may complicate typhoid fever, and the diagnosis should be considered in individuals with acute febrile neurologic illness in endemic areas.

2012·

50citations

·J. Sejvar et al.

PLoS ONE·

DOI

Typhoid and Enteric Fevers in Intensive Care Unit

Typhoid and paratyphoid are caused by Salmonella typhi and Salmonella paratyphi, and require intensive care unit management due to complications like intestinal perforation, peritonitis, and secondary sepsis.

Rigorous Journal

2021·

8citations

·Banambar Ray et al.

Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·

DOI

A Rare Case of Typhoid Fever in the United States Associated With Travel to Mexico

Typhoid fever is rare in the United States, but can be diagnosed through blood culture and treated with ciprofloxacin.

Case ReportRigorous Journal

2022·

3citations

·S. H. Kim et al.

Cureus·

DOI

Case Report: An Imported Case of Typhoid Fever Combined with Rhabdomyolysis and Multiple Organ Lesions in China

Typhoid fever, rhabdomyolysis, and multiple organ damage can be life-threatening, and high creatine kinase and myoglobin levels are useful indicators for evaluating this disease.

Case Report

2023·

1citation

·Qian Huang et al.

The American Journal of Tropical Medicine and Hygiene·

DOI

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