Typhoid

Typhoid is a systemic infection caused by bacteria salmonella Typhi or Paratyphi. It is transmitted by fecal oral route. About 5% of patients become chronic carriers. Its signs and symptoms, diagnosis, and management have been explained below in detail.

Signs and Symptoms

The patients present with

• Early symptoms
  • Fever
  • Myalgias
  • Nausea
  • Vomiting
  • Constipation
• Delayed symptoms
  • At the end of 1st week
  • Splenomegaly
  • Red spots
    • At the end of 2nd week
  • Drowsiness
  • Delirium

Delirium

 Diagnosis of Typhoid

A physician may advise the following investigations.

• CBC– leukopenia
• Blood Culture
• Stool Culture– +ve in 2nd and 3rd weak
• Widal test– detect antibodies against O and H antigen but not specific
• USG
• Lfts
• Rfts

Typhoid Treatment

Ciprofloxacin 500mg is the drug of choice for the treatment of typhoid. Chloramphenicol 500mg four times daily, ampicillin 750mg four times daily and cotrimazole 2 tablets twice daily are also used but most of the cases are resistant. Azithromycin 500mg once daily for 14 days is used in ciprofloxacin resistant cases. Pyrexia may persist for up to five days after the start of specific therapy.

Prevention

Living conditions and improved sanitation reduce the risk of getting the disease. Travelers to endemic countries should be inoculated with one of the three available typhoid vaccines (two inactivated injectable and one oral live attenuated).