Typhoid Fever Questions & Answers

Updated: Aug 19, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Questions & Answers

Overview

What is typhoid fever (enteric fever)?

What is the classic presentation of typhoid fever (enteric fever)?

What is the history of Salmonella typhi (S typhi), and what is the origin of the term typhoid fever?

What is the difference between paratyphoid fever and typhoid fever (enteric fever)?

What is the difference between nontyphoidal salmonellae and S typhi or S paratyphi?

Why does Salmonella typhi (S typhi) have greater infectivity than related serovars?

What is the pathophysiology of Salmonella typhi (S typhi) infection?

How long does Salmonella typhi (S typhi) survive in asymptomatic carriers?

What size inoculum is needed for Salmonella typhi (S typhi) or S paratyphi to cause typhoid fever (enteric fever)?

How is Salmonella typhi (S typhi) transmitted?

How is Salmonella paratyphi (S paratyphi) transmitted?

Who is most at risk for Salmonella paratyphi (S paratyphi) infection?

How does decreased stomach acidity affect the risk of Salmonella typhi (S typhi) infection?

Are individuals with HIV/AIDS at increased risk of Salmonella typhi (S typhi) or S paratyphi infection?

Which genes increase or decrease the risk of typhoid fever (enteric fever)?

In which demographic has there been a recent increase in typhoid fever (enteric fever)?

What is the incidence of typhoid fever (enteric fever) in the US?

What is the global prevalence of typhoid fever (enteric fever)?

What is the mortality rate for treated and untreated typhoid fever (enteric fever)?

Does typhoid fever (enteric fever) have a racial predilection?

Is typhoid fever (enteric fever) more common in men or women?

Is typhoid fever (enteric fever) more common among specific age groups?

Presentation

When should typhoid fever (enteric fever) be suspected?

What are the first signs of typhoid fever (enteric fever)?

Which symptoms develop during the first two weeks of typhoid fever (enteric fever)?

How does typhoid fever (enteric fever) progress in the third week?

What is the clinical course of typhoid fever (enteric fever) after 3 weeks?

Do most cases of typhoid fever (enteric fever) follow a typical clinical course?

Can typhoid fever (enteric fever) cause diarrhea?

What are atypical presentations of typhoid fever (enteric fever)?

How soon after treatment for typhoid fever (enteric fever) does the disease remit?

Which bacteria cause typhoid fever (enteric fever)?

DDX

What are the differential diagnoses for Typhoid Fever?

Workup

Which lab tests are required for the diagnosis of typhoid fever (enteric fever)?

What is the criterion standard for diagnosis of typhoid fever (enteric fever)?

Is culture of bone marrow aspirate useful in the diagnosis of typhoid fever (enteric fever)?

Are blood, intestinal secretions, or stool culture useful in the detection of Salmonella typhi (S typhi) in suspected typhoid fever (enteric fever)?

Are stool culture, urine culture, and cultures of rose spots useful in the detection of Salmonella typhi (S typhi) in suspected typhoid fever (enteric fever)?

Which techniques are used for bone marrow aspiration and blood culture in the diagnosis of typhoid fever (enteric fever)?

Is polymerase chain reaction (PCR) useful in the diagnosis of typhoid fever (enteric fever)?

What specific serologic tests are used in the diagnosis of typhoid fever (enteric fever)?

What nonspecific lab results are common in typhoid fever (enteric fever)?

When are imaging studies warranted in the evaluation of typhoid fever (enteric fever)?

What is the most sensitive method of isolating Salmonella typhi (S typhi)?

What is the typical histologic finding in typhoid fever (enteric fever)?

During the course of typhoid fever (enteric fever), which pathologic stages occur in the intestines?

What are the histologic findings of typhoid fever (enteric fever) outside the intestines?

How is complicated typhoid fever (enteric fever) characterized and how is it treated differently from uncomplicated typhoid fever?

Treatment

Should treatment begin before a diagnosis of typhoid fever (enteric fever) is confirmed?

When can patients with typhoid fever (enteric fever) be treated on an outpatient basis?

Is contact isolation needed in patients hospitalized with typhoid fever (enteric fever)?

When is surgery indicated in typhoid fever (enteric fever)?

Which specialists should be consulted in typhoid fever (enteric fever)?

What are the dietary restrictions in typhoid fever (enteric fever)?

Should physical activity be limited in typhoid fever (enteric fever)?

Follow-up

How common is relapse after treatment for typhoid fever (enteric fever)?

How intense are relapses of typhoid fever (enteric fever)?

Are there antibiotic-resistant strains of Salmonella typhi (S typhi) or S paratyphi?

Does previous infection confer immunity to typhoid fever (enteric fever)?

How often do patients treated for typhoid fever (enteric fever) become chronic carriers of Salmonella typhi (S typhi) or S paratyphi?

For how long should patients with typhoid fever (enteric fever) be hospitalized?

What steps can travelers to endemic areas take to reduce the risk of contracting typhoid fever (enteric fever)?

Is routine vaccination against typhoid fever (enteric fever) recommended in the US?

When should typhoid fever (enteric fever) vaccine be given to individuals traveling to an endemic area?

Are there contraindications to typhoid fever (enteric fever) vaccination?

Which typhoid fever (enteric fever) vaccinations are available?

What is in the Vi capsular polysaccharide (ViCPS) antigen vaccine used in the prevention of typhoid fever (enteric fever)?

What is the dosage of Vi capsular polysaccharide (ViCPS) antigen vaccine used in the prevention of typhoid fever (enteric fever)?

What are potential adverse effects of Vi capsular polysaccharide (ViCPS) antigen vaccine used in the prevention of typhoid fever (enteric fever)?

What is the efficacy of Vi capsular polysaccharide (ViCPS) antigen vaccine used in the prevention of typhoid fever (enteric fever)?

What is in the Ty21a vaccine used in the prevention of typhoid fever (enteric fever)?

What is the dosage of Ty21a vaccine used in the prevention of typhoid fever (enteric fever)?

What are potential adverse effects of Ty21a vaccine used in the prevention of typhoid fever (enteric fever)?

What is the efficacy of Ty21a vaccine used in the prevention of typhoid fever (enteric fever)?

Is the acetone-inactivated parenteral vaccine used in the prevention of typhoid fever (enteric fever) available to the general public?

What are the neuropsychiatric complications of typhoid fever (enteric fever)?

What are respiratory complications of typhoid fever (enteric fever)?

What are cardiovascular complications of typhoid fever (enteric fever)?

What are hepatobiliary complications of typhoid fever (enteric fever)?

What are intestinal complications of typhoid fever (enteric fever)?

What are genitourinary complications of typhoid fever (enteric fever)?

What are hematologic complications of typhoid fever (enteric fever)?

What are musculoskeletal and joint complications of typhoid fever (enteric fever)?

What are late sequelae of typhoid fever (enteric fever)?

What is the prognosis of typhoid fever (enteric fever)?

What education should be given to travelers before they enter regions where typhoid fever (enteric fever) is endemic?

What organizations provide up-to-date information on typhoid fever (enteric fever)?

Medications

Which medications in the drug class Antibiotics are used in the treatment of Typhoid Fever?

Which medications in the drug class Corticosteroids are used in the treatment of Typhoid Fever?