Typhoid fever is caused by the bacterium Salmonella typhi and has 4 stages: fever and cough in stage 1; fever, rash, and diarrhea in stage 2; intestinal bleeding and perforation in stage 3; and delirium in stage 4. It has 4 stages in the body - hyperplasia, necrosis, ulcerative, and healing. It is transmitted through the fecal-oral route via poor sanitation and flies. Diagnosis involves culture of blood, bone marrow or stool and the Widal test. Treatment consists of rehydration and antibiotics like ciprofloxacin. It affects 16-33 million people annually worldwide with over 200,000 deaths, mostly in those aged 5-19.

1. Typhoid Fever
Dr Ashwini Kalantri

2. Signs and Symptoms
4 stages
1. Fever, relative bradycardia, malaise, headache and
cough. Epistaxis. Widal – nagative
2. Fever, bradycardia, delirium, Rose spots. Diarrhea
– pea soup. Hepatosplenomegaly. Widal – positive.
3. Intestinal hemorrhage and perforation. Neuro-
psychiatric symptoms. Encephalitis.
4. Typhoid state. Delirium. Fever falls.

3. Stages
1. Hyperplasia stage
2. Necrosis stage
3. Ulcerative stage
4. Healing stage

4. Salmonella typhi
 rod shaped, flagellated, aerobic, Gram-negative
bacterium

5. Transmission
 Fecal-oral route
 Poor hygiene and sanitation.
 Flies and insects.
 Asymptomatic carrier

6. Diagnosis
 History and examination
 Blood, bone marrow and stool culture.
 Widal test

7. Treatment
 Rehydration
 Quinolones, Ciprofloxacin, Cefixime
 Resistant – Chloramphenicol
 Not fatal with treatment.
 10-30% death if left untreated.

8. Prevention

9. Epidemiology
 16-33 million cases
 200000+ deaths
 Highest incidence – 5-19 year old

10. Distribution