3. Definition of Typhoid fever
Acute enteric infectious disease
Typhoid Fever is a life-threatening illness caused by the
bacterium Salmonella Typhi.
Typhoid Fever is also known as enteric fever, bilious fever
or Yellow Jack.
It is a gram-negative short bacillus that is motile due to its
flagellum
4. Causes of Typhoid fever
FECAL-ORAL TRANSMISSION ROUTE
• The bacteria that cause typhoid fever spread through
contaminated food or water and occasionally through direct
contact with someone who is infected.
• You can also become infected by drinking water contaminated
with the bacteria.
TYPHOID CARRIERS
• Even after treatment with antibiotics, a small number of people
who recover from typhoid fever continue to harbor the bacteria
in their intestinal tracts or gallbladders, often for years. These
people, called chronic carriers, shed the bacteria in their feces
and are capable of infecting others, although they no longer
have signs or symptoms of the disease themselves.
5. Causes of Typhoid fever
Other ways typhoid fever can be contracted include:
Using a toilet contaminated with bacteria and touching your
mouth before washing your hands
Eating seafood from a water source contaminated by infected
faeces or urine
Eating raw vegetables that have been fertilised with human
waste
Contaminated milk products
Having oral or anal sex with a person who's a carrier of
salmonella typhi bacteria
6. Affected Organs
Abdominal Cavity
including:
Liver
Gallbladder
Stomach
Small intestine
Large intestine
7. Symptoms
Signs and symptoms are likely to develop gradually — often appearing one to three
weeks after exposure to the disease.
Symptoms include:
Early illness:
• Fever that starts low and increases daily, possibly reaching as high as 104.9 F (40.5 C)
• Headache
• Weakness and fatigue
• Muscle aches
• Sweating
• Dry cough
• Loss of appetite and weight loss
• Abdominal pain
• Diarrhea or constipation
• Rash
• Extremely swollen abdomen
Typhoid Fever Rash
8. Symptoms
Later illness:
• If you don't receive treatment, you may:
• Become delirious
• Lie motionless and exhausted with your eyes half-closed
in what's known as the typhoid state
9. Stages of Typhoid Fever
Classically, the untreated typhoid fever is broken
down into four different stages, each lasting about
a week.
Stage One:
A slowly rising temperature
Relative bradycardia (unusually slow heart
rate), malaise (discomfort or uneasiness),
headache and cough.
In ¼ of cases, epistaxis (acute hemorrhage from
the nostril, nasal cavity, or nasopharynx) can
occur.
10. Stages of Typhoid Fever
Stage Two:
Continuing high fever
Extremely distended
abdomen
Considerable weight loss
Bradycardia continues
Dicrotic pulse wave
Delirium is frequent,
frequently calm and
sometimes agitated.
11. Stages of Typhoid Fever
Stage Three:
A number of complications can occur:
Intestinal hemorrhage due to bleeding
Intestinal perforation
Encephalitis (inflammation of the brain)
Fever is still very high
Dehydration occurs and increases
delirium
Lies motionless with eyes half-opened
Stage Four:
Defervescence (very high fever)
commences that continues into the fourth
week.
12. RISK FACTOR
If you live in a country where typhoid fever is rare, you're at
increased risk if you:
• Work in or travel to areas where typhoid fever is endemic
• Work as a clinical microbiologist handling Salmonella typhi
bacteria
• Have close contact with someone who is infected or has
recently been infected with typhoid fever
• Drink water contaminated by sewage that contains S. typhi
13. Complications
Intestinal bleeding or holes
• The most serious complications of typhoid fever — intestinal
bleeding or holes (perforations) in the intestine — may develop in
the third week of illness.
Death occurred from the development of other complications such
as:
Intestinal perforation
Kidney Failure
Peritonitis
Infections of the spine
Inflammation of the membranes surrounding the spinal cord and
brain (meningitis)
Inflammation of the heart muscle
Psychiatric problems
14. Complications
Other, less common complications include:
• Inflammation of the heart muscle (myocarditis)
• Inflammation of the lining of the heart and valves (endocarditis)
• Pneumonia
• Inflammation of the pancreas (pancreatitis)
• Kidney or bladder infections
• Infection and inflammation of the membranes and fluid
surrounding your brain and spinal cord (meningitis)
• Psychiatric problems, such as delirium, hallucinations
15. Test & Diagnosis
Diagnosis is made by blood, bone marrow, or
stool.
The Widal test is commonly used to diagnose
Typhoid.
Looks for salmonella antibodies against antigens O-
somatic and H-flagellar)
16. Exams and Tests
An elevated white blood
cell count
A blood culture the shows
the bacteria
A stool culture
An ELISA test to show
the Vi antigen
A platelet count (low
platelet count)
A fluorescent antibody
study
19. Treatments and drugs
Typhoid is treated with
an antibiotic that kills the
Salmonella bacteria.
With antibiotics,
improvement can be
seen in 1-2 days and
recovery in 7-10 days.
Intravenous fluids and
electrolytes may also be
given to patients.Typhoid Vaccine
20. Treatments and drugs
Commonly prescribed antibiotics:
• Ciprofloxacin (Cipro). In the United States, doctors
often prescribe this for nonpregnant adults.
• Ceftriaxone (Rocephin). This injectable antibiotic is an
alternative for people who may not be candidates for
ciprofloxacin, such as children.
21. Other treatments
Other treatments include:
• Drinking fluids. This
helps prevent the
dehydration that results
from a prolonged fever
and diarrhea. If you're
severely dehydrated, you
may need to receive
fluids through a vein
(intravenously).
• Surgery. If your
intestines become
perforated, you'll need
surgery to repair the hole
22. Prevention
Avoid risky foods or
drinks.
Get vaccinated.
Use only clean water.
Avoid raw fruits and
vegetables.
Avoid food and drinks
from street vendor.
Wash your hands.
23. Vaccinations
Two vaccines are
available:
• One is injected in a single
dose at least one week
before travel.
• One is given orally in four
capsules, with one
capsule to be taken every
other day.
Typhoid Vaccination
