Symptoms and Signs of Typhoid Fever (Enteric Fever)

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Medically Reviewed on 3/11/2019

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.

The cause of typhoid fever is infection with the bacterium Salmonella typhi . The 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 gall bladder 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.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.