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 time5 6. Other general symptoms include headache, nausea, loss of appetite, and malaise1 5.
Gastrointestinal Symptoms
Gastrointestinal manifestations are a significant aspect of typhoid fever. Patients often experience abdominal pain, which can be diffuse and severe2 4. Diarrhea and constipation are also common, though the prevalence of each can vary1 3. In severe cases, gastrointestinal complications such as intestinal bleeding, perforation, cholecystitis, and cholangitis may occur2 6.
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 clonus7. Brain MRI scans of affected individuals showed cerebral atrophy, although other abnormalities were not commonly observed7.
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 fever2 4. Hepatosplenomegaly, or the enlargement of the liver and spleen, is another notable sign8.
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 syndrome6. These complications are more likely to occur in patients who have been ill for an extended period before receiving treatment6.
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 JournalCurrent 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.
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.
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.
Case ReportCase 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 ReportTyphoid 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.
Observational StudyRigorous JournalNeurologic 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.
Observational StudyTyphoid 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 JournalA 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 JournalCase 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.
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