Typhoid fever is a life-threatening illness caused by the Salmonella Typhi bacterium. It spreads through contaminated food or water. The disease affects the intestines and other internal organs. Symptoms may include sustained high fever, abdominal pain, diarrhea or constipation. If left untreated, complications can develop including intestinal bleeding or perforation. Diagnosis involves blood tests or stool cultures. Antibiotics are usually prescribed to treat the infection. With treatment, most patients recover fully, but a small percentage may become long-term carriers who continue spreading the bacteria.

2. 
What is Typhoid Fever?
 Typhoid Fever is a life-threatening illness caused
by the bacterium SalmonellaTyphi.
 Typhoid Fever is also known as enteric fever,
bilious fever or Yellow Jack.
 It is a gram-negative short bacillus(pathogenic).

3. Typhoid Fever
 Mode of transmition: fecal oral route.
 After the acute illness about 3%-5% of the people become
carriers of the disease.
 Sometimes the illness goes unnoticed but these people
become long-term carriers.
 Incubation period (10-14 days).

4. Affected Organs
Abdominal Cavity including:
 Liver.
 Gallbladder.
 Stomach.
 Small intestine.
 Large intestine.

5. Clinical features of typhoid
fever
1st week
Fever
Headache
Myalgia
Relative
bradycardia
Constipation
Diarrhoea
and vomiting
in children

6. End of 1st week
Rose spot on
trunk
Splenomegaly
Cough
Abdominal
distention
diarrhoea

7. End of 2nd week

8. .
Stages of Typhoid Fever
Classically, the untreated
typhoid fever is broken down
into four different stages, each
lasting about a week.
Stage One:
A slowly rising temperature.
Relative bradycardia(unusually
slow heart rate).
malaise (discomfort
oruneasiness)
headache and cough.
In ¼ of cases, epistaxis(acute
hemorrhage from the nostril,
nasal cavity, or nasopharynx)
can occur.

9. Stage Two:
Continuing high
fever.
Extremely
distended
abdomen.
Considerable
weight loss.
Bradycardia
continues
Dicrotic pulse wave.
Delirium is frequent.
frequently calm.

10. Stage Three:
A number of complications can occur:
1. Intestinal hemorrhage due to
bleeding.
2. Intestinal perforation.
3. Encephalitis (inflammation of the
brain)
4. Fever is still very high.
5. Dehydration occurs and
6. increases delirium.
7. Lies motionless with eyes half-
Opened.
Stage Four:
 Defervescence (very high fever).
 commences that continues into the
fourth week.

11. Complications
 Death occurred from the
development of other
complications such as:
1. Overwhelming infections.
2. Pneumonia.
3. Intestinal bleeding.
4. Intestinal perforation.
5. Kidney Failure.
6. Peritonitis (inflammation
of the peritoneum, the thin
membrane that lines the
abdominal wall and
covers most of the organs
of the body).

12. Complications Continued ….
Inflammation of the pancreas
Infections of the spine
Inflammation of the
membranes surrounding the
spinal cord and
brain(meningitis)
Inflammation of the heart
muscle
Psychiatric problems

13. Diagnosis
Diagnosis is made by blood, bone marrow,
or stool.
The Widal test is commonly used to
diagnose Typhoid.
Looks for salmonella antibodies against
antigens O-somatic and H-flagellar).

14. Exams and Tests
An elevated white blood cell
count.
A blood culture the shows the
bacteria.
A stool culture.
An ELISA test to show the Vi
antigen.
A platelet count (low platelet
count).
A fluorescent antibody.
Study.

15. Antibody Testing
Fluorescent Antibody Test
 The test checks for the antibody
specific to the S. Typhi bacterium.

16. Antigen Testing
Enzyme-linked immunosorbent
assay(ELISA).
The blood test looks for the antigen
specific to the typhoid bacteria.

17. Carriers of Typhoid
3%-5% of people who
have been infected
become carriers of the
disease.
Carriers are treated with
prolonged antibiotics.
Removal of the
gallbladder or the site
ofthe infection will
usually cure the patient.

18. Typhoid Vaccine
Treatment
Typhoid is treated with an
antibiotic that kills the
Salmonella bacteria.
With antibiotics, improvement
can be seen in 1-2 days and
recovery in 7-10 days.
Intravenous fluids and
electrolytes may also be given
to patients.

19. Treatment
In most cases typhoid fever is not fatal.
Antibiotics such as ampicillin, chloramphenicol,
trimethethoprim-sulfamethoxazole, and
ciprofloxican.
These antibiotics have been used in most
developed countries.

20. Resistance
Resistance to ampicillin, chloramphenicol, trimethoprim-
sulfamethoxazole and streptomycin are common drugs used
against Typhoid but have now become resistant.
These drugs have not been used in over 20 years.
Typhoid that is resistant to multiple drugs is known as multidrug-
resistant typhoid (MDR typhoid).

21. Chloramphenicol
Chloramphenicol
 Chloramphenicol was the original prescribed drug to
patients with Typhoid Fever. However due to certain side
effects, this drug has been replaced by others.

22. Choice of Drugs
 The type of antibiotic prescribed is based on
the region in which the disease originates.
 Bacteria from certain areas in South
America show a resistivity to many
antibiotics.
 Relapses of the disease are dealt with by
the administration of antibiotics.

23. Improvement
 With the use of antibiotics,
improvement can come usually
in the fourth week.
 The fever generally decreases
back down to normal
temperature in 7-10 days.
 Signs and symptoms however,
can return in up to 2 weeks
after the fever has subsided.

24. Fatality
 Before the antibiotic, the death rate
was 20%.
 Antibiotics have reduced the fatality
rate 1%-2%.

25. How can Typhoid be avoided?
1. Avoid risky foods or
drinks.
2. Get vaccinated.
3. Use only clean water..
4. Ask for drinks without ice
unless you know where
it’s coming from.
5. Only eat foods that have
been thoroughly cooked.
6. Avoid raw fruits and
vegetables.
7. Avoid food and drinks
from street vendors.