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==Screening==
==Screening==
There are no screening guidelines for typhoid fever. However, chronic carriers can be screened using elisa detecting antibodies against Vi antigen.<ref>http://www.uspreventiveservicestaskforce.org/</ref><ref name="pmid6192305">{{cite journal| author=Lanata CF, Levine MM, Ristori C, Black RE, Jimenez L, Salcedo M et al.| title=Vi serology in detection of chronic Salmonella typhi carriers in an endemic area. | journal=Lancet | year= 1983 | volume= 2 | issue= 8347 | pages= 441-3 | pmid=6192305 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6192305  }} </ref>
==Natural history and complications==
==Natural history and complications==
==Diagnosis==
==Diagnosis==

Revision as of 13:43, 6 September 2016


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Typhoid fever, also known as enteric fever and Salmonella typhi infection,[1] is an illness caused by the bacterium Salmonella enterica serovar typhi. Common worldwide, it is transmitted by the fecal-oral route — the ingestion of food or water contaminated with feces from an infected person.[2] The bacteria then multiply in the blood stream of the infected person and are absorbed into the digestive tract and eliminated with the waste.

Historical perspective

Around 430–426 B.C., a devastating plague, which some believe to have been typhoid fever, killed one third of the population of Athens, including their leader Pericles. A 2006 study detected DNA sequences similar to those of the bacterium responsible for typhoid fever.[3] Other scientists have disputed the findings, citing serious methodologic flaws in the dental pulp-derived DNA study.[4]The most notorious carrier of typhoid fever—but by no means the most destructive—was Mary Mallon, also known as Typhoid Mary. In 1907, she became the first American carrier to be identified and traced. She was a cook in New York; some believe she was the source of infection for several hundred people. She is closely associated with forty-seven cases and three deaths.In 1897, Almroth Edward Wright developed an effective vaccine. Antibiotics were introduced in clinical practice in 1942, greatly reducing mortality.

Classification

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.[5]

Pathophysiology

The sequence of events in the pathogenesis of typhoid fever include innoculation, gastrointestinal infection, systemic involvement and chronic carrier state.[5][6][7][8][9][10][11][12][13][14][15]

Causes

Typhoid fever is caused by Salmonella enterica serotype Typhi (Salmonella Typhi)[16][17][18][19][20][21]. Salmonella Typhi is a gram negative bacillus, belongs to Enterobacteriaceae family, is flagellated, facultatively anaerobic and contain three important antigens O,H and Vi.[22]

Differentiating typhoid fever from other diseases

Typhoid fever must be differentiated from other diseases that cause fever, diarrhea, and dehydration, such as Ebola, Shigellosis, Malaria, Lassa fever, Brucellosis,Viral hepatitis, leptospirosis, rheumatic fever, typhus, appendicitis, dengue fever,toxoplasmosis, rickettsial diseases, leishmaniasis, tuberculosis and mononucleosis, Abdominal abcess, Yellow fever[23][24][5][25][26]

Epidemiology and Demographics

With an estimated 16-33 million cases of typhoid annually resulting in 500,000 to 600,000 deaths. In 2000, typhoid fever caused an estimated 21.7 million illnesses and 217,000 deaths[27][28]. Worldwide, typhoid fever is most prevalent in areas that are overcrowded with poor hygiene and sanitation. Typhoid fever is still common in the developing world, where it affects about 21.5 million persons each year. 1-6% of the individuals who are infected will develop a chronic infection in the gall bladder[29][30]. Worldwide, the incidence of typhoid fever varies in different parts of world[31][26][32]. Age, race, gender and certain environmental factors affect the distribution of disease among these groups[33][34][35].

Risk factors

Common risk factors in the development of typhoid fever are travel to endemic areas, poor hygiene habits, poor sanitation conditions, flying insects feeding on feces, contact with person recently suffered typhoid fever, recent use of antibiotics, achlorhydria, immunosuppressive illnesses such as AIDS, crowded housing, usage of raw fruits and vegetables contaminated with sewage, prolonged illness, health care workers exposed to typhoid infection, clinical microbiologists handling salmonella typhi, childhood period. [36][37][38][39][40][41]. Presence of C282 mutation and CFTR polymorphism may confer protection against typhoid fever. [42][43][44]

Screening

There are no screening guidelines for typhoid fever. However, chronic carriers can be screened using elisa detecting antibodies against Vi antigen.[45][30]

Natural history and complications

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

References

  1. Kotton C. Typhoid fever. MedlinePlus. URL: http://www.nlm.nih.gov/medlineplus/ency/article/001332.htm. Accessed on: May 4, 2007.
  2. Giannella RA (1996). "Salmonella". Baron's Medical Microbiology (Baron S et al, eds.) (4th ed. ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1.
  3. Papagrigorakis MJ, Yapijakis C, Synodinos PN, Baziotopoulou-Valavani E (2006). "DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens". Int J Infect Dis. 10 (3): 206–14. PMID 16412683}.
  4. Shapiro B, Rambaut A, Gilbert M (2006). "No proof that typhoid caused the Plague of Athens (a reply to Papagrigorakis et al.)". Int J Infect Dis. 10 (4): 334–5, author reply 335–6. PMID 16730469.
  5. 5.0 5.1 5.2 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.
  6. McCormick BA, Miller SI, Carnes D, Madara JL (1995). "Transepithelial signaling to neutrophils by salmonellae: a novel virulence mechanism for gastroenteritis". Infect Immun. 63 (6): 2302–9. PMC 173301. PMID 7768613.
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  15. Keuter, Monique, et al. "Patterns of proinflammatory cytokines and inhibitors during typhoid fever." Journal of Infectious Diseases 169.6 (1994): 1306-1311.
  16. Arndt MB, Mosites EM, Tian M, Forouzanfar MH, Mokhdad AH, Meller M; et al. (2014). "Estimating the burden of paratyphoid a in Asia and Africa". PLoS Negl Trop Dis. 8 (6): e2925. doi:10.1371/journal.pntd.0002925. PMC 4046978. PMID 24901439.
  17. Maskey AP, Day JN, Phung QT, Thwaites GE, Campbell JI, Zimmerman M; et al. (2006). "Salmonella enterica serovar Paratyphi A and S. enterica serovar Typhi cause indistinguishable clinical syndromes in Kathmandu, Nepal". Clin Infect Dis. 42 (9): 1247–53. doi:10.1086/503033. PMID 16586383.
  18. Oboegbulam SI, Oguike JU, Gugnani HC (1995). "Microbiological studies on cases diagnosed as typhoid/enteric fever in south-east Nigeria". J Commun Dis. 27 (2): 97–100. PMID 7499779.
  19. Vollaard AM, Ali S, Widjaja S, Asten HA, Visser LG, Surjadi C; et al. (2005). "Identification of typhoid fever and paratyphoid fever cases at presentation in outpatient clinics in Jakarta, Indonesia". Trans R Soc Trop Med Hyg. 99 (6): 440–50. doi:10.1016/j.trstmh.2004.09.012. PMID 15837356.
  20. Wain J, Hendriksen RS, Mikoleit ML, Keddy KH, Ochiai RL (2015). "Typhoid fever". Lancet. 385 (9973): 1136–45. PMID [//www.ncbi.nlm.nih.gov/pubmed/25458731 doi=10.1016/S0140-6736(13)62708-7 25458731 doi=10.1016/S0140-6736(13)62708-7] Check |pmid= value (help). line feed character in |pmid= at position 9 (help)
  21. http://www.cdc.gov/typhoid-fever/health-professional.html
  22. Fàbrega, Anna, and Jordi Vila. "Salmonella enterica serovar Typhimurium skills to succeed in the host: virulence and regulation." Clinical microbiology reviews 26.2 (2013): 308-341.
  23. "CDC Typhoid Fever". Center for Disease Control. 2005-10-25. Retrieved 2007-10-02.
  24. "Reorganized text". JAMA Otolaryngol Head Neck Surg. 141 (5): 428. 2015. doi:10.1001/jamaoto.2015.0540. PMID 25996397.
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  26. 26.0 26.1 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.
  27. Crump, J. A., & Mintz, E. D (2010). "Global trends in typhoid and paratyphoid fever". Clinical Infectious Diseases. 50 (2): 241–246. doi:10.1086/649541. PMID 20014951.
  28. 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.
  29. Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID doi:10.1093/infdis/146.6.724 Check |pmid= value (help).
  30. 30.0 30.1 Lanata CF, Levine MM, Ristori C, Black RE, Jimenez L, Salcedo M; et al. (1983). "Vi serology in detection of chronic Salmonella typhi carriers in an endemic area". Lancet. 2 (8347): 441–3. PMID 6192305.
  31. 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.
  32. Jensenius M, Han PV, Schlagenhauf P, Schwartz E, Parola P, Castelli F; et al. (2013). "Acute and potentially life-threatening tropical diseases in western travelers--a GeoSentinel multicenter study, 1996-2011". Am J Trop Med Hyg. 88 (2): 397–404. doi:10.4269/ajtmh.12-0551. PMC 3583336. PMID 23324216.
  33. "Typhoid Fever". World Health Organisation. Retrieved 2007-08-28. Check date values in: |accessdate= (help)
  34. Dewan AM, Corner R, Hashizume M, Ongee ET (2013). "Typhoid Fever and its association with environmental factors in the Dhaka Metropolitan Area of Bangladesh: a spatial and time-series approach". PLoS Negl Trop Dis. 7 (1): e1998. doi:10.1371/journal.pntd.0001998. PMC 3554574. PMID 23359825.
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  45. http://www.uspreventiveservicestaskforce.org/

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