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==Overview==
==Overview==
There is no established classification system for typhoid fever. However, typhoid fever may be classified based on duration of illness, serologic type causing disease, severity of illness and virulence factors.
There is no established classification system for typhoid fever. However, typhoid fever may be classified based on duration of illness, serologic type causing disease, severity of illness and virulence factors.<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>


==Classification==
==Classification==
There is no established classification system for typhoid fever. However, typhoid fever may be classified as follows
There is no established classification system for typhoid fever. However, typhoid fever may be classified as follows.<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>
===Duration of illness===
===Duration of illness===
'''Acute disease'''  
'''Acute disease'''  
Line 45: Line 45:
===Virulence factors===
===Virulence factors===
'''High virulence factors'''
'''High virulence factors'''
:*PhoP/phoQ genes
:*PhoP/phoQ genes<ref name="pmid8648213">{{cite journal| author=Hohmann EL, Oletta CA, Killeen KP, Miller SI| title=phoP/phoQ-deleted Salmonella typhi (Ty800) is a safe and immunogenic single-dose typhoid fever vaccine in volunteers. | journal=J Infect Dis | year= 1996 | volume= 173 | issue= 6 | pages= 1408-14 | pmid=8648213 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8648213  }} </ref>
:*CdtB protein
:*CdtB protein<ref name="pmid18191792">{{cite journal| author=Spanò S, Ugalde JE, Galán JE| title=Delivery of a Salmonella Typhi exotoxin from a host intracellular compartment. | journal=Cell Host Microbe | year= 2008 | volume= 3 | issue= 1 | pages= 30-8 | pmid=18191792 | doi=10.1016/j.chom.2007.11.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18191792  }} </ref>
:*Vi antigen positive strains
:*Vi antigen positive strains<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>
 
'''Low virulence factors'''
'''Low virulence factors'''
:*Absence of above factors
:*Absence of above factors
:*Presence of following host factors
:*Presence of following host factors<ref name="pmid26394303">{{cite journal| author=Darton TC, Blohmke CJ, Giannoulatou E, Waddington CS, Jones C, Sturges P et al.| title=Rapidly Escalating Hepcidin and Associated Serum Iron Starvation Are Features of the Acute Response to Typhoid Infection in Humans. | journal=PLoS Negl Trop Dis | year= 2015 | volume= 9 | issue= 9 | pages= e0004029 | pmid=26394303 | doi=10.1371/journal.pntd.0004029 | pmc=4578949 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26394303  }} </ref><ref name="pmid18192769">{{cite journal| author=Weinberg ED| title=Survival advantage of the hemochromatosis C282Y mutation. | journal=Perspect Biol Med | year= 2008 | volume= 51 | issue= 1 | pages= 98-102 | pmid=18192769 | doi=10.1353/pbm.2008.0001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18192769  }} </ref>
::*C282 mutation
::*C282 mutation
::*CFTR mutation
::*CFTR mutation

Revision as of 16:12, 31 August 2016


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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

There is no established classification system for typhoid fever. However, typhoid fever may be classified based on duration of illness, serologic type causing disease, severity of illness and virulence factors.[1]

Classification

There is no established classification system for typhoid fever. However, typhoid fever may be classified as follows.[1]

Duration of illness

Acute disease

  • Sudden in onset
  • Severe by nature
  • Lasts < 12 months
  • Mostly symptomatic

Chronic disease

  • Lasts > 12 months
  • Less severe
  • Asymptomatic

Serological type

Salmonella enterica serotype typhi

  • causes classic typhoid fever syndrome

other serotypes

  • causes typhoid fever like syndrome
  • Salmonella paratyphi A
  • Salmonella paratyphi B
  • Salmonella paratyphi C
  • Salmonella choleraesuis

Severity of illness

Mild disease

  • Early diagnosis and treatment
  • Antibiotic susceptibility
  • Absence of complications

Moderate to severe disease

  • Late presentation
  • Presence of complications
  • Antibiotic resistance

Virulence factors

High virulence factors

  • PhoP/phoQ genes[2]
  • CdtB protein[3]
  • Vi antigen positive strains[1]

Low virulence factors

  • Absence of above factors
  • Presence of following host factors[4][5]
  • C282 mutation
  • CFTR mutation

References

  1. ↑ 1.0 1.1 1.2 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.
  2. ↑ Hohmann EL, Oletta CA, Killeen KP, Miller SI (1996). "phoP/phoQ-deleted Salmonella typhi (Ty800) is a safe and immunogenic single-dose typhoid fever vaccine in volunteers". J Infect Dis. 173 (6): 1408–14. PMID 8648213.
  3. ↑ Spanò S, Ugalde JE, Galán JE (2008). "Delivery of a Salmonella Typhi exotoxin from a host intracellular compartment". Cell Host Microbe. 3 (1): 30–8. doi:10.1016/j.chom.2007.11.001. PMID 18191792.
  4. ↑ Darton TC, Blohmke CJ, Giannoulatou E, Waddington CS, Jones C, Sturges P; et al. (2015). "Rapidly Escalating Hepcidin and Associated Serum Iron Starvation Are Features of the Acute Response to Typhoid Infection in Humans". PLoS Negl Trop Dis. 9 (9): e0004029. doi:10.1371/journal.pntd.0004029. PMC 4578949. PMID 26394303.
  5. ↑ 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.

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