Typhoid fever,
also known as typhoid, is a common worldwide illness, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella typhi.
The classic presentation includes fever, malaise, diffuse abdominal pain, and constipation.
Untreated, typhoid fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death within one month of onset.
Survivors may be left with long-term or permanent neuro-psychiatric complications.
Flying insects feeding on feces may occasionally transfer the bacteria through poor hygiene habits and public sanitation conditions.
Public education campaigns encouraging people to wash their hands after defecating and before handling food are an important component in controlling spread of the disease.
Diagnosis is made by any blood, bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and H-flagellar).
Where resistance is uncommon, the treatment of choice is a fluoroquinolone such as ciprofloxacin otherwise, a third-generation cephalosporin such as ceftriaxone or cefotaxime is the first choice Cefixime is a suitable oral alternative.
Typhoid fever in most cases is not fatal.
Antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, Amoxicillin and ciprofloxacin, have been commonly used to treat typhoid fever in developed countries.
Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%.
Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.
Typhoid does not affect animals and therefore transmission is only from human to human.
Typhoid can only spread in environments where human feces or urine are able to come into contact with food or drinking water.
Careful food preparation and washing of hands are crucial to preventing typhoid.
