Symptoms and Signs of Typhoid Fever (Enteric Fever)

Doctor's Notes on Typhoid Fever (Enteric Fever)

Typhoid fever (enteric fever) is a potentially life-threatening infectious disease caused by Salmonella typhi bacteria that can, if untreated, have a 10%-30% mortality rate due to intestinal hemorrhage or perforation. The classic signs and symptoms are

• a sustained high fever (103-104 F),
• fatigue,
• loss of appetite, and
• headache.

Untreated, the symptoms can last for months in some individuals. Other signs and symptoms include a slow heart rate, abdominal pains, diarrhea, and/or constipation. Some patients develop a rash on their chest and abdomen (flat and rose-colored rash termed rose spots), and some have enlarged livers and spleens.

Salmonella typhi bacteria are ingested in contaminated food or fluids, enter ileal tissue, survive in macrophage cells, are carried to the lymphatic system, and then can enter the blood. Some Salmonella typhi reach the gallbladder and then are shed into the feces, ready to infect others. Some people become carriers; they shed bacteria but do not have active signs or symptoms.

What Are the Treatments for Typhoid Fever?

Antibiotic therapy is the only effective treatment for typhoid fever. The antibiotics that are used to treat this bacterial infection include the following:

• Ciprofloxacin
• Ofloxacin
• Azithromycin
• Ceftriaxone (IV only) -- severe infections, used in children instead of ciprofloxacin

If the infecting strain of bacteria are resistant to certain antibiotics, your doctor may choose other antimicrobials. Other supportive treatments may include IV fluids to replace fluid losses and surgery if the weakened intestine develops holes.