Typhoid fever

Alternative names:

enteric fever

Definition:

A bacterial infection characterized by diarrhea, systemic disease, and a rash; most commonly caused by Salmonella typhi.

Causes, incidence, and risk factors:

Typhi are spread by contaminated food, drink, or water. Following ingestion, the bacteria spread from the intestine to the intestinal lymph nodes, liver, and spleen via the blood where they multiply. Salmonella may directly infect the gallbladder through the hepatic duct or spread to other areas of the body through the bloodstream.

Early symptoms are very general and include fever, malaise and abdominal pain. As the disease progresses the fever becomes higher (greater than 103 Fahrenheit), and diarrhea becomes prominent. Weakness, profound fatigue, delirium, obtundation and an acutely ill appearance develop. A rash, characteristic only of typhoid and called "rose spots," appears in most cases of typhoid. Rose spots are small (1/4 inch) dark red, flat spots that appear most often on the abdomen and chest. Typically, children have milder disease and fewer complications than adults.

A few people can become carriers of typhoid and continue to shed the bacteria in their feces for years. Although typhoid is common in developing countries, less than 600 cases are reported in the U.S. each year.