Typhoid fever is a serious infection caused by Salmonella typhi, typically transmitted through contaminated food or water. Symptoms appear 1 to 3 weeks post-exposure and include fever, chills, and gastrointestinal issues, with complications like internal bleeding and bowel perforation occurring primarily in untreated cases. Prevention relies on improved sanitation, access to clean water, good hygiene practices, and vaccination.

1. Presentation

2. Introduction
Typhoid fever is a life-threatening infection caused by the
bacterium Salmonella Typhi. It is usually spread through contaminated
food or water. Once Salmonella Typhi bacteria are ingested, they
multiply and spread into the bloodstream.

3. Etiology
1. Caused by the bacterium salmonella typhoid
2. Ingestion of contaminated food or water
3. Contact with acute onset of typhoid
4. Eating food or drinking beverages that handled by a person carrying
the bacteria

4. Symptoms
 Symptoms are likely to start slowly, often showing up 1 to 3 weeks
after exposure to the bacteria.
 Fever that starts low and increases throughout the day
• Chills.
• Headache.
• Weakness and fatigue.
• Muscle aches.
• Stomach pain.
• Diarrhea or constipation.
• Rash.

5. Risk factor
 Work in or travel to areas where typhoid fever is
established, especially if you travel to visit family or
friends.
• Work as a clinical microbiologist handling Salmonella
enterica serotype typhi bacteria.
• Have close contact with someone who is infected or has
recently been infected with typhoid fever.

7. Complications
 Complications caused by typhoid fever usually only happen in people who
haven't been treated with appropriate antibiotics or who weren't treated
straight away
 The 2 most common complications in untreated typhoid fever are:
• internal bleeding in the digestive system
• splitting (perforation) of a section of the digestive system or bowel, which
spreads the infection to nearby tissue

8. Internal bleeding
 Most internal bleeding that happens in typhoid fever isn't life threatening, but it can make you
feel very unwell.
 Symptoms include:
• feeling tired all the time
• breathlessness
• pale skin
• an irregular heartbeat
• vomiting blood
• poo that's very dark or tar-like
 A blood transfusion may be required to replace lost blood, and surgery can be used to repair the
site of the bleeding.

9. Perforation
 Perforation is potentially a very serious complication. This is
because bacteria that live in your digestive system can move into
your stomach and infect the lining of your abdomen (the
peritoneum). This is known as peritonitis.

10. Investigations
Widal test
CBC – Leucopenia with relative lymphocytosis
Blood culture- During 1st week of illness
Stool culture – During 3rd week
Urine culture – During 4th week

11. Treatment
 Activity – rest is helpful
 Medical care
 Antibiotics
 Corticosteroids
 Diet – fluid and electrolyte should be monitored

12. Antibiotics
 Fluoroquinolone ( drug of choice )
 Ampicillin (750mg)
 Ciprofloxacin (500mg)
 3rd generation of cephalosporin – ceftriaxone , cefotaxime,

13. prevention
 Typhoid fever is common in places with poor sanitation and a lack
of safe drinking water. Access to safe water and adequate sanitation,
hygiene among food handlers and typhoid vaccination are all
effective in preventing typhoid fever