Typhoid Fever

What you need to know

Fever is a symptom of many illnesses characterized by high temperature, cold sweats, nausea, vomiting and restlessness. It is a major indicator of bacterial infections and results when the white blood cells combat the infecting bacteria. There are many kinds of fever, Malaria fever, viral hemorrhagic fever and Typhoid Fever.

Typhoid Fever is caused by Salmonella typhi which is also referred to as enteric fever. This type of fever is more severe than that caused by Entero Invasive Escherichia Coli and Shigella. It begins with invasion of epithelial cells, and regional lymph nodes, and finally multiple organ systems.

Salmonella typhi is an intracellular parasite meaning it can live inside the cell as a result, during invasion of the blood stream, some the bacteria get phagocytosed by white blood cells and can survive for as long as possible

The symptoms start 1- 3 weeks after infection and include, fever, headache and abdominal pain that is either diffuse or localized to the right lower quadrant similar to appendicitis. Following inflammation of the infected organs, the spleen may enlarge and the patient develops diarrhea and visible rose spots on the abdomen.

Some people recovering from typhoid fever become chronic carriers of Salmonella typhi, evenly distributed in their gallbladders and excreting the bacteria constantly. These type of people have no active infection and thus express no symptoms. Contamination of food and water also causes spread and infection.

Asplenic individuals are the most vulnerable to Salmonella infections. This is because our immune system which clears encapsulated bacteria such as Salmonella by opsonizing with antibodies and phagocytizing with the spleen, so patients who have lost their spleen either from trauma or from sickle-cell disease have difficulty clearing Salmonella and thus are more susceptible.

Typhoid fever is diagnosed by culturing the blood, urine or stool in a clinical microbiology laboratory. Treatment with Ciprofloxacin or ceftriaxone is considered appropriate therapy.

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