Typhoid fever

• It is also known as Salmonella typhi or commonly

just typhoid, is a common worldwide illness, transmitted by the
ingestion of food or water contaminated with the feces of an
infected person.
• Around 430–424 BC, a devastating plague, which some
believe to have been typhoid fever, killed one third of the
population of Athens, including their leader Pericles.
• The bacteria then perforate through the intestinal wall and
are phagocytosed by macrophages.
• The classic Widal test is negative in the first week.
• In the second week of the infection, the patient lies
prostrate with high fever in plateau around 40 °C (104 °F)
and bradycardia (sphygmothermic dissociation), classically with
a dicrotic pulse wave.
• Delirium is frequent, frequently calm, but sometimes
agitated.
• The abdomen is distended and painful in the right lower
quadrant where borborygmi can be heard.
• Diarrhea can occur in this stage: six to eight stools in a
day, green with a characteristic smell, comparable to pea soup.
However, constipation is also frequent.
• The spleen and liver are enlarged (hepatosplenomegaly) and
tender, and there is elevation of liver transaminases.
• The Widal reaction is strongly positive with anti O and
anti H antibodies.
• Blood cultures are sometimes still positive at this stage.
(The major symptom of this fever is the fever usually rises in the
afternoon up to the first and second week.)
• In the third week of typhoid fever, a number of
complications can occur intestinal hemorrhage due to bleeding in
congested Peyer's patches; this can be very serious but is usually not
fatal.
• Sanitation and hygiene are the critical measures that can
be taken to prevent typhoid.
• Typhoid fever in most cases is not fatal.
• It is caused by the bacterium Salmonella typhi
• The organism is a Gram-negative short bacillus that is
motile due to its peritrichous flagella. The bacterium grows best at
37 °C/99 °F – human body temperature.
• This fever received various names, such as gastric
fever, abdominal typhus, infantile remittant fever, slow
fever, nervous fever, pythogenic fever, etc.
• Resistance to ampicillin, chloramphenicol, trimethoprim-
sulfamethoxazole and streptomycin is now common, and these
agents have not been used as first line treatment now for almost 20
years.
• The name of “typhoid " was given by Louis in 1829, as a
derivative from typhus.
• The impact of this disease falls sharply with the
application of modern sanitation techniques.
• Most developed countries saw declining rates of typhoid
fever throughout the first half of the 20th century due to
vaccinations and advances in public sanitation and hygiene.