Typhoid fever natural history, complications and prognosis: Difference between revisions
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== Natural history == | == Natural history == | ||
*The symptoms of typhoid fever usually develop after 5 to 21 days of ingestion of causative organism. However, incubation period of disease varies based on several factors such as size of innoculum, age of the patient and immunological status of patient. | |||
*In first week of illness, patient develops fever and malaise. Initially, it is low grade, but it rises progressively and is high and sustained by the second week of illness. | |||
*If left untreated, patient develops complications in second or third week of illness | |||
Without therapy, the illness may last for 3 to 4 weeks and death rates range between 12% and 30%.Even if your symptoms seem to go away, you may still be carrying S. Typhi . If so, the illness could return, or you could pass the disease to other people. In fact, if you work at a job where you handle food or care for small children, you may be barred legally from going back to work until a doctor has determined that you no longer carry any typhoid bacteria. | Without therapy, the illness may last for 3 to 4 weeks and death rates range between 12% and 30%.Even if your symptoms seem to go away, you may still be carrying S. Typhi . If so, the illness could return, or you could pass the disease to other people. In fact, if you work at a job where you handle food or care for small children, you may be barred legally from going back to work until a doctor has determined that you no longer carry any typhoid bacteria. | ||
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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
Natural history
- The symptoms of typhoid fever usually develop after 5 to 21 days of ingestion of causative organism. However, incubation period of disease varies based on several factors such as size of innoculum, age of the patient and immunological status of patient.
- In first week of illness, patient develops fever and malaise. Initially, it is low grade, but it rises progressively and is high and sustained by the second week of illness.
- If left untreated, patient develops complications in second or third week of illness
Without therapy, the illness may last for 3 to 4 weeks and death rates range between 12% and 30%.Even if your symptoms seem to go away, you may still be carrying S. Typhi . If so, the illness could return, or you could pass the disease to other people. In fact, if you work at a job where you handle food or care for small children, you may be barred legally from going back to work until a doctor has determined that you no longer carry any typhoid bacteria.
Complications
Common complications of typhoid fever include:[1][2][3][4][5][6][7][8][9][10][11][12]
Gastrointestinal
- Intestinal perforation(1 to 3%)
- Intestinal hemorrhage(10%)
- Hepatitis
- Colecystitis(subclinical)
Neurologiocal
- Typhoid encephalopathy
- Meningitis
- Acute psychosis
- Myelitis
- Delirium
- Rigidity
- Disordered sleep pattern
Cardiovascular
- Myocarditis
- Shock
- Asymptomatic ECG changes
Respiratory
Heamatologic
Other
- Chronic carrier state
- Focal Abcess
- Relapse(5 to 10%)
- Miscarriage
Prognosis
If you are being treated for typhoid fever, it is important to do the following:
- Keep taking the prescribed antibiotics for as long as the doctor has asked you to take them.
- Wash your hands carefully with soap and water after using the bathroom, and do not prepare or serve food for other people. This will lower the chance that you will pass the infection on to someone else.
- Have your doctor perform a series of stool cultures to ensure that no S. Typhi bacteria remain in your body.
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.
- ↑ van Basten JP, Stockenbrügger R (1994). "Typhoid perforation. A review of the literature since 1960". Trop Geogr Med. 46 (6): 336–9. PMID 7892698.
- ↑ 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.
- ↑ 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.
- ↑ Seoud M, Saade G, Uwaydah M, Azoury R (1988). "Typhoid fever in pregnancy". Obstet Gynecol. 71 (5): 711–4. PMID 3357660.
- ↑ Reed RP, Klugman KP (1994). "Neonatal typhoid fever". Pediatr Infect Dis J. 13 (9): 774–7. PMID 7808844.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.