Typhoid fever natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Typhoid fever}} | {{Typhoid fever}} | ||
{{CMG}}; {{AE}}{{ | {{CMG}}; {{AE}}{{AAA}} | ||
== Overview == | == Overview == | ||
Symptoms of typhoid fever, which usually begin to develop 5 to 21 days after [[ingestion]] of the causative organism, include [[fever]], [[headache]], [[malaise]], and bradycardia. If left untreated, the patient will develop complications in the second or third week of illness such as [[intestinal perforation]], intestinal [[hemorrhage]], typhoid encephalopathy, [[meningitis]], [[disseminated intravascular coagulation]], [[miscarriage]], or [[relapse]].<ref>Bitar, Roger, and John Tarpley. "Intestinal perforation in typhoid fever: a historical and state-of-the-art review." Review of Infectious Diseases 7.2 (1985): 257-271.</ref><ref name="pmid7892698">{{cite journal| author=van Basten JP, Stockenbrügger R| title=Typhoid perforation. A review of the literature since 1960. | journal=Trop Geogr Med | year= 1994 | volume= 46 | issue= 6 | pages= 336-9 | pmid=7892698 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7892698 }} </ref><ref name="pmid6361558">{{cite journal| author=Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR et al.| title=Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone. | journal=N Engl J Med | year= 1984 | volume= 310 | issue= 2 | pages= 82-8 | pmid=6361558 | doi=10.1056/NEJM198401123100203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6361558 }} </ref><ref name="pmid3050856">{{cite journal| author=Punjabi NH, Hoffman SL, Edman DC, Sukri N, Laughlin LW, Pulungsih SP et al.| title=Treatment of severe typhoid fever in children with high dose dexamethasone. | journal=Pediatr Infect Dis J | year= 1988 | volume= 7 | issue= 8 | pages= 598-600 | pmid=3050856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3050856 }} </ref><ref name="pmid3357660">{{cite journal| author=Seoud M, Saade G, Uwaydah M, Azoury R| title=Typhoid fever in pregnancy. | journal=Obstet Gynecol | year= 1988 | volume= 71 | issue= 5 | pages= 711-4 | pmid=3357660 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3357660 }} </ref><ref name="pmid7808844">{{cite journal| author=Reed RP, Klugman KP| title=Neonatal typhoid fever. | journal=Pediatr Infect Dis J | year= 1994 | volume= 13 | issue= 9 | pages= 774-7 | pmid=7808844 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7808844 }} </ref><ref name="pmid10405386">{{cite journal| author=Wain J, Hien TT, Connerton P, Ali T, Parry CM, Chinh NT et al.| title=Molecular typing of multiple-antibiotic-resistant Salmonella enterica serovar Typhi from Vietnam: application to acute and relapse cases of typhoid fever. | journal=J Clin Microbiol | year= 1999 | volume= 37 | issue= 8 | pages= 2466-72 | pmid=10405386 | doi= | pmc=85257 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10405386 }} </ref><ref>Levine, Myron M., Robert E. Black, and Claudio Lanata. "Precise estimation of the numbers of chronic carriers of Salmonella typhi in Santiago, Chile, an endemic area." Journal of Infectious Diseases 146.6 (1982): 724-726.</ref><ref name="pmid3837121">{{cite journal| author=Gupta SP, Gupta MS, Bhardwaj S, Chugh TD| title=Current clinical patterns of typhoid fever: a prospective study. | journal=J Trop Med Hyg | year= 1985 | volume= 88 | issue= 6 | pages= 377-81 | pmid=3837121 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3837121 }} </ref><ref name="pmid15919620">{{cite journal| author=Huang DB, DuPont HL| title=Problem pathogens: extra-intestinal complications of Salmonella enterica serotype Typhi infection. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 6 | pages= 341-8 | pmid=15919620 | doi=10.1016/S1473-3099(05)70138-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15919620 }} </ref><ref name="pmid22357702">{{cite journal| author=Lutterloh E, Likaka A, Sejvar J, Manda R, Naiene J, Monroe SS et al.| title=Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= 1100-6 | pmid=22357702 | doi=10.1093/cid/cis012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22357702 }} </ref><ref name="pmid22357703">{{cite journal| author=Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD et al.| title=A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= 1091-9 | pmid=22357703 | doi=10.1093/cid/cis025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22357703 }} </ref> Without therapy, the illness may last for 3 to 4 weeks and mortality rates range between 12% and 30%. The prognosis of typhoid fever varies depending on the incidence rate. The mortality rate of typhoid fever in endemic areas is 1-4% with treatment, while it is less than 1% with treatment in areas with low incidence of typhoid fever.<ref name="pmid3484760">{{cite journal| author=Daul CB, deShazo RD, Andes WA, Pankey GA| title=Immunologic studies in homosexual and hemophiliac subjects with persistent generalized lymphadenopathy: a comparative analysis. | journal=J Allergy Clin Immunol | year= 1986 | volume= 77 | issue= 2 | pages= 295-301 | pmid=3484760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3484760 }} </ref><ref name="pmid19706859">{{cite journal| author=Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J et al.| title=Typhoid fever in the United States, 1999-2006. | journal=JAMA | year= 2009 | volume= 302 | issue= 8 | pages= 859-65 | pmid=19706859 | doi=10.1001/jama.2009.1229 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19706859 }} </ref> | Symptoms of typhoid fever, which usually begin to develop 5 to 21 days after [[ingestion]] of the causative organism, include [[fever]], [[headache]], [[malaise]], and bradycardia. If left untreated, the patient will develop complications in the second or third week of illness such as [[intestinal perforation]], intestinal [[hemorrhage]], typhoid [[encephalopathy]], [[meningitis]], [[disseminated intravascular coagulation]], [[miscarriage]], or [[relapse]].<ref>Bitar, Roger, and John Tarpley. "Intestinal perforation in typhoid fever: a historical and state-of-the-art review." Review of Infectious Diseases 7.2 (1985): 257-271.</ref><ref name="pmid7892698">{{cite journal| author=van Basten JP, Stockenbrügger R| title=Typhoid perforation. A review of the literature since 1960. | journal=Trop Geogr Med | year= 1994 | volume= 46 | issue= 6 | pages= 336-9 | pmid=7892698 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7892698 }} </ref><ref name="pmid6361558">{{cite journal| author=Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR et al.| title=Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone. | journal=N Engl J Med | year= 1984 | volume= 310 | issue= 2 | pages= 82-8 | pmid=6361558 | doi=10.1056/NEJM198401123100203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6361558 }} </ref><ref name="pmid3050856">{{cite journal| author=Punjabi NH, Hoffman SL, Edman DC, Sukri N, Laughlin LW, Pulungsih SP et al.| title=Treatment of severe typhoid fever in children with high dose dexamethasone. | journal=Pediatr Infect Dis J | year= 1988 | volume= 7 | issue= 8 | pages= 598-600 | pmid=3050856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3050856 }} </ref><ref name="pmid3357660">{{cite journal| author=Seoud M, Saade G, Uwaydah M, Azoury R| title=Typhoid fever in pregnancy. | journal=Obstet Gynecol | year= 1988 | volume= 71 | issue= 5 | pages= 711-4 | pmid=3357660 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3357660 }} </ref><ref name="pmid7808844">{{cite journal| author=Reed RP, Klugman KP| title=Neonatal typhoid fever. | journal=Pediatr Infect Dis J | year= 1994 | volume= 13 | issue= 9 | pages= 774-7 | pmid=7808844 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7808844 }} </ref><ref name="pmid10405386">{{cite journal| author=Wain J, Hien TT, Connerton P, Ali T, Parry CM, Chinh NT et al.| title=Molecular typing of multiple-antibiotic-resistant Salmonella enterica serovar Typhi from Vietnam: application to acute and relapse cases of typhoid fever. | journal=J Clin Microbiol | year= 1999 | volume= 37 | issue= 8 | pages= 2466-72 | pmid=10405386 | doi= | pmc=85257 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10405386 }} </ref><ref>Levine, Myron M., Robert E. Black, and Claudio Lanata. "Precise estimation of the numbers of chronic carriers of Salmonella typhi in Santiago, Chile, an endemic area." Journal of Infectious Diseases 146.6 (1982): 724-726.</ref><ref name="pmid3837121">{{cite journal| author=Gupta SP, Gupta MS, Bhardwaj S, Chugh TD| title=Current clinical patterns of typhoid fever: a prospective study. | journal=J Trop Med Hyg | year= 1985 | volume= 88 | issue= 6 | pages= 377-81 | pmid=3837121 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3837121 }} </ref><ref name="pmid15919620">{{cite journal| author=Huang DB, DuPont HL| title=Problem pathogens: extra-intestinal complications of Salmonella enterica serotype Typhi infection. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 6 | pages= 341-8 | pmid=15919620 | doi=10.1016/S1473-3099(05)70138-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15919620 }} </ref><ref name="pmid22357702">{{cite journal| author=Lutterloh E, Likaka A, Sejvar J, Manda R, Naiene J, Monroe SS et al.| title=Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= 1100-6 | pmid=22357702 | doi=10.1093/cid/cis012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22357702 }} </ref><ref name="pmid22357703">{{cite journal| author=Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD et al.| title=A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= 1091-9 | pmid=22357703 | doi=10.1093/cid/cis025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22357703 }} </ref> Without therapy, the illness may last for 3 to 4 weeks and mortality rates range between 12% and 30%. The prognosis of typhoid fever varies depending on the local incidence rate. The mortality rate of typhoid fever in endemic areas is 1-4% with treatment, while it is less than 1% with treatment in areas with low incidence of typhoid fever.<ref name="pmid3484760">{{cite journal| author=Daul CB, deShazo RD, Andes WA, Pankey GA| title=Immunologic studies in homosexual and hemophiliac subjects with persistent generalized lymphadenopathy: a comparative analysis. | journal=J Allergy Clin Immunol | year= 1986 | volume= 77 | issue= 2 | pages= 295-301 | pmid=3484760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3484760 }} </ref><ref name="pmid19706859">{{cite journal| author=Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J et al.| title=Typhoid fever in the United States, 1999-2006. | journal=JAMA | year= 2009 | volume= 302 | issue= 8 | pages= 859-65 | pmid=19706859 | doi=10.1001/jama.2009.1229 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19706859 }} </ref> | ||
== Natural history == | == Natural history == | ||
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*[[Rose spots]] on the lower chest and abdomen (1/3 patients) | *[[Rose spots]] on the lower chest and abdomen (1/3 patients) | ||
*[[Rhonchi]] in lung bases | *[[Rhonchi]] in lung bases | ||
* | *[[Abdominal pain]] (right lower quadrant) | ||
*[[Diarrhea]] (six to eight stools/day), green with a characteristic smell, comparable to pea-soup<ref name="pmid1899554">{{cite journal| author=Gotuzzo E, Frisancho O, Sanchez J, Liendo G, Carrillo C, Black RE et al.| title=Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area. | journal=Arch Intern Med | year= 1991 | volume= 151 | issue= 2 | pages= 381-2 | pmid=1899554 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1899554 }} </ref> | *[[Diarrhea]] (six to eight stools/day), green with a characteristic smell, comparable to pea-soup<ref name="pmid1899554">{{cite journal| author=Gotuzzo E, Frisancho O, Sanchez J, Liendo G, Carrillo C, Black RE et al.| title=Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area. | journal=Arch Intern Med | year= 1991 | volume= 151 | issue= 2 | pages= 381-2 | pmid=1899554 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1899554 }} </ref> | ||
*[[Constipation]] | *[[Constipation]] | ||
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== Prognosis== | == Prognosis== | ||
Worldwide, the [[prognosis]] of typhoid fever varies depending on the incidence rate. The [[mortality]] rate of typhoid fever in [[endemic]] areas is 1-4% with treatment as compared to 10-30% without treatment.<ref name="pmid3484760">{{cite journal| author=Daul CB, deShazo RD, Andes WA, Pankey GA| title=Immunologic studies in homosexual and hemophiliac subjects with persistent generalized lymphadenopathy: a comparative analysis. | journal=J Allergy Clin Immunol | year= 1986 | volume= 77 | issue= 2 | pages= 295-301 | pmid=3484760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3484760 }} </ref> However, the mortality rate in the areas with low [[incidence]] of typhoid fever is less than 1% with treatment.<ref name="pmid19706859">{{cite journal| author=Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J et al.| title=Typhoid fever in the United States, 1999-2006. | journal=JAMA | year= 2009 | volume= 302 | issue= 8 | pages= 859-65 | pmid=19706859 | doi=10.1001/jama.2009.1229 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19706859 }} </ref> | Worldwide, the [[prognosis]] of typhoid fever varies depending on the local incidence rate. The [[mortality]] rate of typhoid fever in [[endemic]] areas is 1-4% with treatment as compared to 10-30% without treatment.<ref name="pmid3484760">{{cite journal| author=Daul CB, deShazo RD, Andes WA, Pankey GA| title=Immunologic studies in homosexual and hemophiliac subjects with persistent generalized lymphadenopathy: a comparative analysis. | journal=J Allergy Clin Immunol | year= 1986 | volume= 77 | issue= 2 | pages= 295-301 | pmid=3484760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3484760 }} </ref> However, the mortality rate in the areas with low [[incidence]] of typhoid fever is less than 1% with treatment.<ref name="pmid19706859">{{cite journal| author=Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J et al.| title=Typhoid fever in the United States, 1999-2006. | journal=JAMA | year= 2009 | volume= 302 | issue= 8 | pages= 859-65 | pmid=19706859 | doi=10.1001/jama.2009.1229 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19706859 }} </ref> | ||
*''' | *'''Favorable prognostic factors:''' | ||
:*Early diagnosis and treatment<ref name="pmid1489205">{{cite journal| author=Swan SK, Gilbert DN, Kohlhepp SJ, Leggett JE, Kohnen PW, Bennett WM| title=Duration of the protective effect of polyaspartic acid on experimental gentamicin nephrotoxicity. | journal=Antimicrob Agents Chemother | year= 1992 | volume= 36 | issue= 11 | pages= 2556-8 | pmid=1489205 | doi= | pmc=284375 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1489205 }} </ref> | :*Early diagnosis and treatment<ref name="pmid1489205">{{cite journal| author=Swan SK, Gilbert DN, Kohlhepp SJ, Leggett JE, Kohnen PW, Bennett WM| title=Duration of the protective effect of polyaspartic acid on experimental gentamicin nephrotoxicity. | journal=Antimicrob Agents Chemother | year= 1992 | volume= 36 | issue= 11 | pages= 2556-8 | pmid=1489205 | doi= | pmc=284375 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1489205 }} </ref> | ||
:*Susceptibility to drugs<ref>Bhutta, Zulfiqar A., and Husein Lalji Dewraj. "Current concepts in the diagnosis and treatment of typhoid fever." British Medical Journal 7558 (2006): 78.</ref> | :*Susceptibility to drugs<ref>Bhutta, Zulfiqar A., and Husein Lalji Dewraj. "Current concepts in the diagnosis and treatment of typhoid fever." British Medical Journal 7558 (2006): 78.</ref> | ||
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:*Good compliance | :*Good compliance | ||
*''' | *'''Poor prognostic factors:''' | ||
:*Extremes of age<ref name="pmid:10.1136/adc.75.3.214">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=:10.1136/adc.75.3.214 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref><ref>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.</ref> | :*Extremes of age<ref name="pmid:10.1136/adc.75.3.214">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=:10.1136/adc.75.3.214 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref><ref>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.</ref> | ||
:*[[Immunodeficiency]]<ref name="pmid22401289">{{cite journal| author=Chalya PL, Mabula JB, Koy M, Kataraihya JB, Jaka H, Mshana SE et al.| title=Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting. | journal=World J Emerg Surg | year= 2012 | volume= 7 | issue= | pages= 4 | pmid=22401289 | doi=10.1186/1749-7922-7-4 | pmc=3311140 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22401289 }} </ref> | :*[[Immunodeficiency]]<ref name="pmid22401289">{{cite journal| author=Chalya PL, Mabula JB, Koy M, Kataraihya JB, Jaka H, Mshana SE et al.| title=Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting. | journal=World J Emerg Surg | year= 2012 | volume= 7 | issue= | pages= 4 | pmid=22401289 | doi=10.1186/1749-7922-7-4 | pmc=3311140 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22401289 }} </ref> | ||
Line 103: | Line 103: | ||
:*Poor [[compliance]] with treatment<ref name="pmid12456854">{{cite journal| author=Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ| title=Typhoid fever. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 22 | pages= 1770-82 | pmid=12456854 | doi=10.1056/NEJMra020201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12456854 }} </ref> | :*Poor [[compliance]] with treatment<ref name="pmid12456854">{{cite journal| author=Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ| title=Typhoid fever. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 22 | pages= 1770-82 | pmid=12456854 | doi=10.1056/NEJMra020201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12456854 }} </ref> | ||
:*Chronic carrier state (gall bladder carcinoma)<ref name="pmid3578539">{{cite journal| author=Van Belle H, Goossens F, Wynants J| title=Formation and release of purine catabolites during hypoperfusion, anoxia, and ischemia. | journal=Am J Physiol | year= 1987 | volume= 252 | issue= 5 Pt 2 | pages= H886-93 | pmid=3578539 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3578539 }} </ref> | :*Chronic carrier state (gall bladder carcinoma)<ref name="pmid3578539">{{cite journal| author=Van Belle H, Goossens F, Wynants J| title=Formation and release of purine catabolites during hypoperfusion, anoxia, and ischemia. | journal=Am J Physiol | year= 1987 | volume= 252 | issue= 5 Pt 2 | pages= H886-93 | pmid=3578539 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3578539 }} </ref> | ||
:*Multidrug resistance<ref name="pmid8976660">{{cite journal| author=Bhutta ZA| title=Impact of age and drug resistance on mortality in typhoid fever. | journal=Arch Dis Child | year= 1996 | volume= 75 | issue= 3 | pages= 214-7 | pmid=8976660 | doi= | pmc=1511710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8976660 }} </ref> | :*[[Multidrug resistance]]<ref name="pmid8976660">{{cite journal| author=Bhutta ZA| title=Impact of age and drug resistance on mortality in typhoid fever. | journal=Arch Dis Child | year= 1996 | volume= 75 | issue= 3 | pages= 214-7 | pmid=8976660 | doi= | pmc=1511710 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8976660 }} </ref> | ||
== References == | == References == | ||
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Latest revision as of 02:40, 18 July 2021
Typhoid fever Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Typhoid fever natural history, complications and prognosis On the Web |
American Roentgen Ray Society Images of Typhoid fever natural history, complications and prognosis |
FDA on Typhoid fever natural history, complications and prognosis |
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Risk calculators and risk factors for Typhoid fever natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Aslam, M.B.B.S[2]
Overview
Symptoms of typhoid fever, which usually begin to develop 5 to 21 days after ingestion of the causative organism, include fever, headache, malaise, and bradycardia. If left untreated, the patient will develop complications in the second or third week of illness such as intestinal perforation, intestinal hemorrhage, typhoid encephalopathy, meningitis, disseminated intravascular coagulation, miscarriage, or relapse.[1][2][3][4][5][6][7][8][9][10][11][12] Without therapy, the illness may last for 3 to 4 weeks and mortality rates range between 12% and 30%. The prognosis of typhoid fever varies depending on the local incidence rate. The mortality rate of typhoid fever in endemic areas is 1-4% with treatment, while it is less than 1% with treatment in areas with low incidence of typhoid fever.[13][14]
Natural history
The symptoms of typhoid fever usually develop 5 to 21 days after ingestion of the causative organism.[12][15][16][17][18]
First Week | Second Week[12] | Third Week | Fourth Week[16][19] |
---|---|---|---|
|
|
|
|
Complications
Common complications of typhoid fever include:[2][3][4][5][6][7][9][10][11][21][22]
Gastrointestinal
Neurologiocal
- Typhoid encephalopathy[10][24]
- Meningitis
- Acute psychosis
- Myelitis
- Delirium
- Rigidity
- Disordered sleep pattern
Cardiovascular
- Myocarditis
- Shock[9]
- Asymptomatic ECG changes
Respiratory
Heamatologic
Other
- Chronic carrier state
- Focal abscess
- Relapse[7]
- Miscarriage[5]
Prognosis
Worldwide, the prognosis of typhoid fever varies depending on the local incidence rate. The mortality rate of typhoid fever in endemic areas is 1-4% with treatment as compared to 10-30% without treatment.[13] However, the mortality rate in the areas with low incidence of typhoid fever is less than 1% with treatment.[14]
- Favorable prognostic factors:
- Poor prognostic factors:
- Extremes of age[28][29]
- Immunodeficiency[30]
- Limited resources for treatment[31]
- Poor compliance with treatment[31]
- Chronic carrier state (gall bladder carcinoma)[32]
- Multidrug resistance[33]
References
- ↑ Bitar, Roger, and John Tarpley. "Intestinal perforation in typhoid fever: a historical and state-of-the-art review." Review of Infectious Diseases 7.2 (1985): 257-271.
- ↑ 2.0 2.1 van Basten JP, Stockenbrügger R (1994). "Typhoid perforation. A review of the literature since 1960". Trop Geogr Med. 46 (6): 336–9. PMID 7892698.
- ↑ 3.0 3.1 3.2 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.
- ↑ 4.0 4.1 Punjabi NH, Hoffman SL, Edman DC, Sukri N, Laughlin LW, Pulungsih SP; et al. (1988). "Treatment of severe typhoid fever in children with high dose dexamethasone". Pediatr Infect Dis J. 7 (8): 598–600. PMID 3050856.
- ↑ 5.0 5.1 5.2 Seoud M, Saade G, Uwaydah M, Azoury R (1988). "Typhoid fever in pregnancy". Obstet Gynecol. 71 (5): 711–4. PMID 3357660.
- ↑ 6.0 6.1 Reed RP, Klugman KP (1994). "Neonatal typhoid fever". Pediatr Infect Dis J. 13 (9): 774–7. PMID 7808844.
- ↑ 7.0 7.1 7.2 Wain J, Hien TT, Connerton P, Ali T, Parry CM, Chinh NT; et al. (1999). "Molecular typing of multiple-antibiotic-resistant Salmonella enterica serovar Typhi from Vietnam: application to acute and relapse cases of typhoid fever". J Clin Microbiol. 37 (8): 2466–72. PMC 85257. PMID 10405386.
- ↑ Levine, Myron M., Robert E. Black, and Claudio Lanata. "Precise estimation of the numbers of chronic carriers of Salmonella typhi in Santiago, Chile, an endemic area." Journal of Infectious Diseases 146.6 (1982): 724-726.
- ↑ 9.0 9.1 9.2 Gupta SP, Gupta MS, Bhardwaj S, Chugh TD (1985). "Current clinical patterns of typhoid fever: a prospective study". J Trop Med Hyg. 88 (6): 377–81. PMID 3837121.
- ↑ 10.0 10.1 10.2 Huang DB, DuPont HL (2005). "Problem pathogens: extra-intestinal complications of Salmonella enterica serotype Typhi infection". Lancet Infect Dis. 5 (6): 341–8. doi:10.1016/S1473-3099(05)70138-9. PMID 15919620.
- ↑ 11.0 11.1 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.
- ↑ 12.0 12.1 12.2 12.3 Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD; et al. (2012). "A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009". Clin Infect Dis. 54 (8): 1091–9. doi:10.1093/cid/cis025. PMID 22357703.
- ↑ 13.0 13.1 Daul CB, deShazo RD, Andes WA, Pankey GA (1986). "Immunologic studies in homosexual and hemophiliac subjects with persistent generalized lymphadenopathy: a comparative analysis". J Allergy Clin Immunol. 77 (2): 295–301. PMID 3484760.
- ↑ 14.0 14.1 14.2 Lynch MF, Blanton EM, Bulens S, Polyak C, Vojdani J, Stevenson J; et al. (2009). "Typhoid fever in the United States, 1999-2006". JAMA. 302 (8): 859–65. doi:10.1001/jama.2009.1229. PMID 19706859.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID http://dx.doi.org/10.1016/S0140-6736(98)09 Check
|pmid=
value (help). - ↑ 16.0 16.1 Crump JA, Luby SP, Mintz ED (2004). "The global burden of typhoid fever". Bull World Health Organ. 82 (5): 346–53. PMC 2622843. PMID 15298225.
- ↑ Khanam F, Sayeed MA, Choudhury FK, Sheikh A, Ahmed D, Goswami D; et al. (2015). "Typhoid fever in young children in Bangladesh: clinical findings, antibiotic susceptibility pattern and immune responses". PLoS Negl Trop Dis. 9 (4): e0003619. doi:10.1371/journal.pntd.0003619. PMC 4388457. PMID 25849611.
- ↑ Bose KS, Sarma RH (1975). "Delineation of the intimate details of the backbone conformation of pyridine nucleotide coenzymes in aqueous solution". Biochem Biophys Res Commun. 66 (4): 1173–9. PMID Epidemiology, clinical presentation, labo result2 Epidemiology, clinical presentation, labo Check
|pmid=
value (help). - ↑ http://www.cdc.gov/typhoid-fever/symptoms.html
- ↑ 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.
- ↑ Levine, Myron M., Robert E. Black, and Claudio Lanata. "Precise estimation of the numbers of chronic carriers of Salmonella typhi in Santiago, Chile, an endemic area." Journal of Infectious Diseases 146.6 (1982): 724-726.
- ↑ Bitar, Roger, and John Tarpley. "Intestinal perforation in typhoid fever: a historical and state-of-the-art review." Review of Infectious Diseases 7.2 (1985): 257-271.
- ↑ Bitar, Roger, and John Tarpley. "Intestinal perforation in typhoid fever: a historical and state-of-the-art review." Review of Infectious Diseases 7.2 (1985): 257-271.
- ↑ Ali G, Rashid S, Kamli MA, Shah PA, Allaqaband GQ (1997). "Spectrum of neuropsychiatric complications in 791 cases of typhoid fever". Trop Med Int Health. 2 (4): 314–8. PMID 9171838.
- ↑ Swan SK, Gilbert DN, Kohlhepp SJ, Leggett JE, Kohnen PW, Bennett WM (1992). "Duration of the protective effect of polyaspartic acid on experimental gentamicin nephrotoxicity". Antimicrob Agents Chemother. 36 (11): 2556–8. PMC 284375. PMID 1489205.
- ↑ Bhutta, Zulfiqar A., and Husein Lalji Dewraj. "Current concepts in the diagnosis and treatment of typhoid fever." British Medical Journal 7558 (2006): 78.
- ↑ Wain J, Hendriksen RS, Mikoleit ML, Keddy KH, Ochiai RL (2015). "Typhoid fever". Lancet. 385 (9973): 1136–45. doi:10.1016/S0140-6736(13)62708-7. PMID 25458731.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID :10.1136/adc.75.3.214 Check
|pmid=
value (help). - ↑ 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.
- ↑ Chalya PL, Mabula JB, Koy M, Kataraihya JB, Jaka H, Mshana SE; et al. (2012). "Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting". World J Emerg Surg. 7: 4. doi:10.1186/1749-7922-7-4. PMC 3311140. PMID 22401289.
- ↑ 31.0 31.1 Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ (2002). "Typhoid fever". N Engl J Med. 347 (22): 1770–82. doi:10.1056/NEJMra020201. PMID 12456854.
- ↑ Van Belle H, Goossens F, Wynants J (1987). "Formation and release of purine catabolites during hypoperfusion, anoxia, and ischemia". Am J Physiol. 252 (5 Pt 2): H886–93. PMID 3578539.
- ↑ Bhutta ZA (1996). "Impact of age and drug resistance on mortality in typhoid fever". Arch Dis Child. 75 (3): 214–7. PMC 1511710. PMID 8976660.