TYPHOID FEVER

General Information

DEFINITION--A bacterial infection of the gastrointestinal tract. A relatively mild attack may be mistaken for simple gastroenteritis.

BODY PARTS INVOLVED--Gastrointestinal tract; skin; central nervous system.

SEX OR AGE MOST AFFECTED--Both sexes; all ages. Infants and persons over 60 usually have the severest cases.

SIGNS & SYMPTOMS

• Diarrhea. In mild cases, this may be only 2 or 3 loose bowel movements a day. In severe cases, it may be watery diarrhea as often as every 10 or 15 minutes.
• Vomiting.
• Fever.
• Headache.
• Muscle aches.
• Rose-colored skin rash on the abdomen.
• Abdominal cramps (sometimes).
• Blood in the stool (sometimes). A relatively mild attack may be mistaken for simple gastroenteritis.

CAUSES--Infection with Salmonella typhi, a bacteria found in infected animals and transmitted to persons in contaminated meat or milk. Thorough cooking kills the germ. The infection can also be transmitted by ill persons or non-ill carriers who handle food without careful handwashing after bowel movements.

RISK INCREASES WITH

• Illness that has lowered resistance.
• Crowded or unsanitary living conditions.
• Travel to tropical countries.

HOW TO PREVENT

• For travel to countries where typhoid is present, consider vaccination for typhoid (injection or oral form).
• During tropical travel, avoid tap water, salad and raw vegetables, unpeeled fruits and dairy products.
• Avoid poultry or poultry products left unrefrigerated for prolonged period of time.
• Wash your hands after bowel movements and before handling food.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for severe cases; others can be cared for at home.

POSSIBLE COMPLICATIONS

• Dehydration.
• Perforation of the intestines.
• Gastrointestinal hemorrhage or abscess.
• Pneumonia.
• Bone infection.
• Congestive heart failure.
• Hepatitis.

PROBABLE OUTCOME--Usually curable in 2 to 3 weeks with treatment. Without treatment, it can be fatal.

How To Treat

GENERAL MEASURES----For home-care:

• Isolate ill persons and have them use bedside commodes or a separate bathroom.
• Use a heating pad or hot-water bottle to relieve abdominal cramps.
• Wash hands carefully and often.
• Turn patients frequently in bed.
• Apply lukewarm wet towels to the groin and underarms to reduce fever. Don't use aspirin or acetaminophen; both irritate the gastrointestinal tract. Don't use laxatives.

MEDICATION--Your doctor may prescribe:

• Antibiotics.
• For severe cases, glucocorticoids in addition to antibiotics.

ACTIVITY--Bed rest is necessary until all symptoms have been gone at least 3 days. The legs should be flexed often in bed to prevent formation of deep-vein blood clots.

DIET--A clear-liquid diet (see Liquid Diet in Appendix) is necessary during the diarrhea phase. Later, a high-calorie, well-balanced diet is necessary. Vitamin and mineral supplements may be helpful.

Call Your Doctor If

• You have symptoms of typhoid fever.
• The following occurs during treatment: Fever. Sore throat. Severe cough or coughing up blood. Shortness of breath. Severe abdominal pain or swelling. Rectal bleeding. Pain in the calf or leg. Headache, earache or swollen joints.