Typhoid infection - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Typhoid (enteric) fever mostly occurs in low-income countries where sanitary conditions remain poor and water supplies are not treated.
Transmission occurs through consumption of contaminated food or water.
In high-income countries, enteric fever is mainly seen among travelers returning from endemic areas.
Prolonged febrile illness with normal white blood cell count in returnees from an endemic area should increase suspicion.
Definitive diagnosis depends on bacterial isolation, usually by blood culture.

Rose spots on abdomen of a patient with typhoid fever

CDC/Armed Forces Institute of Pathology, Charles N. Farmer; used with permission

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Incidence rates (per 100 000) of typhoid and paratyphoid fevers, by country, in 2017
Incidence of typhoid infection (left) and the percentage of travelers (right)
Rose spots on the chest of a patient with typhoid fever
Rose spots on abdomen of a patient with typhoid fever
Typhoid fever cholecystitis with an ulceration and perforation of the gallbladder into the jejunum

Citations

Key Articles

World Health Organization. Typhoid vaccines position paper. Mar 2018 [internet publication].[Full Text]
Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ. 2004 May;82(5):346-53.[Abstract][Full Text]
Schwartz E, Shlim DR, Eaton M, et al. The effect of oral and parenteral typhoid vaccination on the rate of infection with Salmonella typhi and Salmonella paratyphi A among foreigners in Nepal. Arch Intern Med. 1990 Feb;150(2):349-51.[Abstract]
Ochiai RL, Wang X, von Seidlein L, et al. Salmonella paratyphi A rates, Asia. Emerg Infect Dis. 2005 Nov;11(11):1764-6.[Abstract][Full Text]
Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - typhoid & paratyphoid fever. May 2023 [internet publication].[Full Text]
Engels EA, Falagas ME, Lau J, et al. Typhoid fever vaccines: a meta-analysis of studies on efficacy and toxicity. BMJ. 1998 Jan 10;316(7125):110-6.[Abstract][Full Text]
Jackson BR, Iqbal S, Mahon B; Centers for Disease Control and Prevention (CDC). Updated recommendations for the use of typhoid vaccine - Advisory Committee on Immunization Practices, United States, 2015. MMWR Morb Mortal Wkly Rep. 2015 Mar 27;64(11):305-8.[Abstract][Full Text]
Frenck RW Jr, Nakhla I, Sultan Y, et al. Azithromycin versus ceftriaxone for the treatment of uncomplicated typhoid fever in children. Clin Infect Dis. 2000 Nov;31(5):1134-8.[Abstract][Full Text]

Other Online Resources

CDC: typhoid fever
CDC: travelers' health - disease directory

Referenced Articles

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