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==Overview==
==Overview==
Obtaining history is the most important aspect of making a diagnosis of typhoid fever
==History==
==History==
*Obtaining history is the most important aspect of making a diagnosis of typhoid fever. It provides insight into cause, risk factors, and associated comorbid conditions. Complete history will help determine the correct therapy and helps in determining the prognosis. Symptomatic presentation of the patient depends mainly on the clinical stage of typhoid fever. Key points in history which can lead to diagnosis of typhoid fever include<ref name="pmid9593481">{{cite journal| author=Luby SP, Faizan MK, Fisher-Hoch SP, Syed A, Mintz ED, Bhutta ZA et al.| title=Risk factors for typhoid fever in an endemic setting, Karachi, Pakistan. | journal=Epidemiol Infect | year= 1998 | volume= 120 | issue= 2 | pages= 129-38 | pmid=9593481 | doi= | pmc=2809381 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9593481  }} </ref><ref name="pmid2870432">{{cite journal| author=Marshall E, Howells RE| title=Turnover of the surface proteins of adult and third and fourth stage larval Brugia pahangi. | journal=Mol Biochem Parasitol | year= 1986 | volume= 18 | issue= 1 | pages= 17-24 | pmid=2870432 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2870432  }} </ref><ref name="pmid17596250">{{cite journal| author=Srikantiah P, Vafokulov S, Luby SP, Ishmail T, Earhart K, Khodjaev N et al.| title=Epidemiology and risk factors for endemic typhoid fever in Uzbekistan. | journal=Trop Med Int Health | year= 2007 | volume= 12 | issue= 7 | pages= 838-47 | pmid=17596250 | doi=10.1111/j.1365-3156.2007.01853.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17596250  }} </ref><ref>Mermin, Jonathan H., et al. "A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water." Journal of Infectious Diseases 179.6 (1999): 1416-1422.</ref><ref>Black, Robert E., et al. "Case—control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile." Bulletin of the World Health Organization 63.5 (1985): 899.</ref>
*Obtaining history is the most important aspect of making a diagnosis of typhoid fever. It provides insight into cause, risk factors, and associated comorbid conditions. Complete history will help determine the correct therapy and helps in determining the prognosis. Symptomatic presentation of the patient depends mainly on the clinical stage of typhoid fever. Key points in history which can lead to diagnosis of typhoid fever include<ref name="pmid9593481">{{cite journal| author=Luby SP, Faizan MK, Fisher-Hoch SP, Syed A, Mintz ED, Bhutta ZA et al.| title=Risk factors for typhoid fever in an endemic setting, Karachi, Pakistan. | journal=Epidemiol Infect | year= 1998 | volume= 120 | issue= 2 | pages= 129-38 | pmid=9593481 | doi= | pmc=2809381 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9593481  }} </ref><ref name="pmid2870432">{{cite journal| author=Marshall E, Howells RE| title=Turnover of the surface proteins of adult and third and fourth stage larval Brugia pahangi. | journal=Mol Biochem Parasitol | year= 1986 | volume= 18 | issue= 1 | pages= 17-24 | pmid=2870432 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2870432  }} </ref><ref name="pmid17596250">{{cite journal| author=Srikantiah P, Vafokulov S, Luby SP, Ishmail T, Earhart K, Khodjaev N et al.| title=Epidemiology and risk factors for endemic typhoid fever in Uzbekistan. | journal=Trop Med Int Health | year= 2007 | volume= 12 | issue= 7 | pages= 838-47 | pmid=17596250 | doi=10.1111/j.1365-3156.2007.01853.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17596250  }} </ref><ref>Mermin, Jonathan H., et al. "A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water." Journal of Infectious Diseases 179.6 (1999): 1416-1422.</ref><ref>Black, Robert E., et al. "Case—control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile." Bulletin of the World Health Organization 63.5 (1985): 899.</ref>

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Obtaining history is the most important aspect of making a diagnosis of typhoid fever

History

  • Obtaining history is the most important aspect of making a diagnosis of typhoid fever. It provides insight into cause, risk factors, and associated comorbid conditions. Complete history will help determine the correct therapy and helps in determining the prognosis. Symptomatic presentation of the patient depends mainly on the clinical stage of typhoid fever. Key points in history which can lead to diagnosis of typhoid fever include[1][2][3][4][5]
  • Residence in endemic area
  • Recent travel history to endemic area[6]
  • Recent use of antibiotics, antacids or proton pump inhibitors
  • Medical conditions causing acchlorydia such as pernicious anemia
  • History of immunosuppressive illness such as AIDS
  • Poor hygiene and sanitation conditions
  • Contact history with person already having typhoid
  • Occupational history such as health care workers and laboratory personnel handling Salmonella typhi.
  • Past history showing cystic fibrosis and haemachromatosis may help rule out typhoid fever.[7][8][9]
  • Symptoms showing febrile illness with typical stepwise rise in temperature with non specific abdominal complaints and other constitutional symptoms such as malaise, headache and rash.[10]

Symptoms

Symptoms of typhoid fever include the following:[11][12][13][14][15][15][16][17][18][19][20]

Most common symptoms

  • Stepledder increase in temperature initially and than sustained fever as high as 40°C (104°F)[12]
  • Profuse sweating
  • Influenza-like symptoms with chills
  • Malaise
  • headache[15]
  • Poorly localised abdominal pain[18]
  • Diarrhea[21]
  • Constipation
  • Loss of apatite
  • Nausea[18]

Less common symptoms

  • Rash causing flat, rose-colored spots [22]
  • Nose bleed
  • Confusion
  • Frank rigors
  • Rigidity
  • Pain in joints

References

  1. ↑ Luby SP, Faizan MK, Fisher-Hoch SP, Syed A, Mintz ED, Bhutta ZA; et al. (1998). "Risk factors for typhoid fever in an endemic setting, Karachi, Pakistan". Epidemiol Infect. 120 (2): 129–38. PMC 2809381. PMID 9593481.
  2. ↑ Marshall E, Howells RE (1986). "Turnover of the surface proteins of adult and third and fourth stage larval Brugia pahangi". Mol Biochem Parasitol. 18 (1): 17–24. PMID 2870432.
  3. ↑ Srikantiah P, Vafokulov S, Luby SP, Ishmail T, Earhart K, Khodjaev N; et al. (2007). "Epidemiology and risk factors for endemic typhoid fever in Uzbekistan". Trop Med Int Health. 12 (7): 838–47. doi:10.1111/j.1365-3156.2007.01853.x. PMID 17596250.
  4. ↑ Mermin, Jonathan H., et al. "A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water." Journal of Infectious Diseases 179.6 (1999): 1416-1422.
  5. ↑ Black, Robert E., et al. "Case—control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile." Bulletin of the World Health Organization 63.5 (1985): 899.
  6. ↑ Ekdahl, Karl, Birgitta de Jong, and Yvonne Andersson. "Risk of travel-associated typhoid and paratyphoid fevers in various regions." Journal of travel medicine 12.4 (2005): 197-204.
  7. ↑ Weinberg ED (2008). "Survival advantage of the hemochromatosis C282Y mutation". Perspect Biol Med. 51 (1): 98–102. doi:10.1353/pbm.2008.0001. PMID 18192769.
  8. ↑ Moalem S, Weinberg ED, Percy ME (2004). "Hemochromatosis and the enigma of misplaced iron: implications for infectious disease and survival". Biometals. 17 (2): 135–9. PMID 15088940.
  9. ↑ van de Vosse E, de Visser AW, Al-Attar S, Vossen R, Ali S, van Dissel JT (2010). "Distribution of CFTR variations in an Indonesian enteric fever cohort". Clin Infect Dis. 50 (9): 1231–7. doi:10.1086/651598. PMID 20233062.
  10. ↑ Christie AB. Infectious Diseases, Epidemiology and Clinical Practice. Edinburgh; Churchill Livingstone, 1987
  11. ↑ Butler T, Islam A, Kabir I, Jones PK (1991). "Patterns of morbidity and mortality in typhoid fever dependent on age and gender: review of 552 hospitalized patients with diarrhea". Rev Infect Dis. 13 (1): 85–90. PMID 2017639.
  12. ↑ 12.0 12.1 STUART BM, PULLEN RL (1946). "Typhoid; clinical analysis of 360 cases". Arch Intern Med (Chic). 78 (6): 629–61. PMID 20278487.
  13. ↑ "CDC Typhoid Fever". Center for Disease Control. 2005-10-25. Retrieved 2007-10-02.
  14. ↑ Gotuzzo E, Frisancho O, Sanchez J, Liendo G, Carrillo C, Black RE; et al. (1991). "Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area". Arch Intern Med. 151 (2): 381–2. PMID 1899554.
  15. ↑ 15.0 15.1 15.2 Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR; et al. (1984). "Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone". N Engl J Med. 310 (2): 82–8. doi:10.1056/NEJM198401123100203. PMID 6361558.
  16. ↑ Lutterloh E, Likaka A, Sejvar J, Manda R, Naiene J, Monroe SS; et al. (2012). "Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border". Clin Infect Dis. 54 (8): 1100–6. doi:10.1093/cid/cis012. PMID 22357702.
  17. ↑ Butler, Thomas, et al. "Patterns of Morbidity and Mortality in Typhoid Fever Dependent on Age and Gender: Review of 552 Hopitalized Patients with Diarrhea." Review of Infectious Diseases 13.1 (1991): 85-90.
  18. ↑ 18.0 18.1 18.2 Pohan HT (2004). "Clinical and laboratory manifestations of typhoid fever at Persahabatan Hospital, Jakarta". Acta Med Indones. 36 (2): 78–83. PMID 15673941.
  19. ↑ Thriemer K, Ley B, Ley BB, Ame SS, Deen JL, Pak GD; et al. (2012). "Clinical and epidemiological features of typhoid fever in Pemba, Zanzibar: assessment of the performance of the WHO case definitions". PLoS One. 7 (12): e51823. doi:10.1371/journal.pone.0051823. PMC 3527440. PMID 23284780.
  20. ↑ Haq SA, Alam MN, Hossain SM, Ahmed T, Tahir M (1997). "Value of clinical features in the diagnosis of enteric fever". Bangladesh Med Res Counc Bull. 23 (2): 42–6. PMID 9465434.
  21. ↑ Butler, Thomas, et al. "Patterns of Morbidity and Mortality in Typhoid Fever Dependent on Age and Gender: Review of 552 Hopitalized Patients with Diarrhea." Review of Infectious Diseases 13.1 (1991): 85-90.
  22. ↑ "CDC Typhoid Fever". Center for Disease Control. 2005-10-25. Retrieved 2007-10-02.

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