Typhoid fever natural history, complications and prognosis: Difference between revisions
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== Prognosis == | == Prognosis == | ||
The risk of death may be as high as 25% without treatment, while with treatment it is between 1 and 4%. | |||
== References == | == References == | ||
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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.
- 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 such as intestinal hemorrhage, bleeding and other life threatening illnesses[1].
- Without therapy, the illness may last for 3 to 4 weeks and death rates range between 12% and 30%. However, approximately 10 percent of patients with untreated typhoid excrete S. enterica serotype typhi in the feaces for up to three months, 1 to 4 percent become long-term carriers, and excrete the organism for more than one year[2].
Complications
Common complications of typhoid fever include:[3][4][5][6][7][8][9][10][11][12][13]
Gastrointestinal
- Intestinal perforation(1 to 3%)[14][1]
- Intestinal hemorrhage(10%)
- Hepatitis
- Cholecystitis(subclinical)
Neurologiocal
- Typhoid encephalopathy[12][15]
- Meningitis
- Acute psychosis
- Myelitis
- Delirium
- Rigidity
- Disordered sleep pattern
Cardiovascular
- Myocarditis
- Shock[11]
- Asymptomatic ECG changes
Respiratory
Heamatologic
Other
- Chronic carrier state
- Focal Abcess
- Relapse(5 to 10%)[9]
- Miscarriage[7]
Prognosis
The risk of death may be as high as 25% without treatment, while with treatment it is between 1 and 4%.
References
- ↑ 1.0 1.1 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.
- ↑ 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.
- ↑ 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.
- ↑ 7.0 7.1 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.
- ↑ 9.0 9.1 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.
- ↑ 11.0 11.1 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.
- ↑ 12.0 12.1 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.
- ↑ 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.