Typhoid fever history and symptoms

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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

History

Symptoms

Symptoms of typhoid fever include the following:^[1]^[2]^[3]^[4]^[5]^[5]^[6]^[7]^[8]^[9]^[10]

Most common symptoms

Stepledder increase in temperature initially and than sustained fever as high as 40°C (104°F)^[2]
Profuse sweating
Influenza-like symptoms with chills
Malaise
headache^[5]
Poorly localised abdominal pain^[8]
Diarrhea^[11]
Constipation
Loss of apatite
Nausea^[8]

Less common symptoms

Rash causing flat, rose-colored spots ^[12]

Course of typhoid fever

Typhoid fever symptoms can be divided into four individual stages, each lasting approximately one week.

First week

Slowly rising temperature with relative bradycardia,
malaise
headache
cough.
Epistaxis
abdominal pain

Second week

Prostration
High grade fever which plateaus around 40°C
Bradycardia (Sphygmo-thermic dissociation), classically with a dicrotic pulse wave.
Delirium or agitation (nervous fever)
Rose spots on the lower chest and abdomen(1/3 patients).
Rhonchi in lung bases.
Painful abdomen(right lower quadrant).
Diarrhea (six to eight stools/day), green with a characteristic smell, comparable to pea-soup.^[4]
Constipation

Third week

Intestinal hemorrhage
Intestinal perforation in distal ileum(Fatal)
septicaemia or diffuse peritonitis^[5]
Encephalitis
Metastatic abscesses
Cholecystitis
Endocarditis
Osteitis
Defervescence

References

↑ 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.
↑ ^2.0 ^2.1 STUART BM, PULLEN RL (1946). "Typhoid; clinical analysis of 360 cases". Arch Intern Med (Chic). 78 (6): 629–61. PMID 20278487.
↑ "CDC Typhoid Fever". Center for Disease Control. 2005-10-25. Retrieved 2007-10-02.
↑ ^4.0 ^4.1 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.
↑ ^5.0 ^5.1 ^5.2 ^5.3 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.
↑ 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.
↑ 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.
↑ ^8.0 ^8.1 ^8.2 Pohan HT (2004). "Clinical and laboratory manifestations of typhoid fever at Persahabatan Hospital, Jakarta". Acta Med Indones. 36 (2): 78–83. PMID 15673941.
↑ 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.
↑ 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.
↑ 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.
↑ "CDC Typhoid Fever". Center for Disease Control. 2005-10-25. Retrieved 2007-10-02.

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[pmid2017639-1] 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.

[pmid20278487-2] 2.0 ^2.1 STUART BM, PULLEN RL (1946). "Typhoid; clinical analysis of 360 cases". Arch Intern Med (Chic). 78 (6): 629–61. PMID 20278487.

[3] "CDC Typhoid Fever". Center for Disease Control. 2005-10-25. Retrieved 2007-10-02.

[pmid1899554-4] 4.0 ^4.1 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.

[pmid6361558-5] 5.0 ^5.1 ^5.2 ^5.3 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.

[pmid22357702-6] 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.

[7] 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.

[pmid15673941-8] 8.0 ^8.1 ^8.2 Pohan HT (2004). "Clinical and laboratory manifestations of typhoid fever at Persahabatan Hospital, Jakarta". Acta Med Indones. 36 (2): 78–83. PMID 15673941.

[pmid23284780-9] 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.

[pmid9465434-10] 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.

[11] 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.

[12] "CDC Typhoid Fever". Center for Disease Control. 2005-10-25. Retrieved 2007-10-02.

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