Definition: Typhoid fever is a systemic illness caused by Salmonella typhi or Salmonella paratyphi, transmitted through contaminated food or water.
- Symptoms:
- Fever (often high, 39–40°C)
- Headache, malaise, and myalgias
- Relative bradycardia (pulse lower than expected for fever)
- Abdominal pain, constipation, or diarrhea
- Rose spots (transient, non-itchy rash) in ~20–30% of cases
- Diagnosis:
- Blood culture (gold standard, but sensitivity decreases after 5–7 days of illness)
- Stool culture (less sensitive)
- Widal test (not recommended due to low specificity)
- Treatment:
- First-line: Ceftriaxone (3rd-generation cephalosporin) or azithromycin (if resistance suspected)
- Alternative: Ciprofloxacin (if local resistance is low)
- Supportive care: Hydration, antipyretics (avoid NSAIDs if dengue not ruled out)
- Prevention:
- Vaccination (Ty21a oral vaccine or Vi polysaccharide vaccine)
- Safe food/water practices, hand hygiene
Rationale: Typhoid fever is a serious illness requiring prompt diagnosis and treatment to prevent complications (e.g., intestinal perforation, sepsis). Antibiotic resistance is increasing, so local resistance patterns should guide therapy.