What is Typhoid fever – Causes, symptoms ,treatment, diagnosis,Prevention

Typhoid fever is a bacterial infection caused by Salmonella enterica serotype Typhi. It primarily affects the intestinal tract and bloodstream and is contracted through contaminated food, water, or close contact with an infected person. Typhoid fever is more common in areas with poor sanitation and limited access to clean water, particularly in parts of Asia, Africa, and Latin America.

Cause:

• The bacterium Salmonella Typhi is responsible for typhoid fever.
• It spreads through the fecal-oral route, meaning ingestion of food or water contaminated by the feces or urine of an infected person.

Pathophysiology:

Once ingested, Salmonella Typhi passes through the stomach and is absorbed in the intestines, where it invades the intestinal wall and multiplies in the lymphatic system. The bacteria then enter the bloodstream, leading to bacteremia, and spread to other organs such as the liver, spleen, and gallbladder.

Symptoms:

Typhoid fever typically develops gradually over 1–2 weeks after exposure and can last for several weeks if untreated. Common symptoms include:

1. Fever: Often rising in a stepwise fashion, reaching as high as 103–104°F (39–40°C).
2. Headache: A severe and persistent headache is common.
3. Weakness and Fatigue: General body weakness and lethargy.
4. Abdominal Pain: Cramping and discomfort, especially in the lower abdomen.
5. Diarrhea or Constipation: Children may experience diarrhea, while adults are more prone to constipation.
6. Rose-Colored Spots: Small, flat, rose-colored spots may appear on the abdomen or chest.
7. Loss of Appetite: Accompanied by significant weight loss.
8. Cough: A dry cough may develop during the early stages.

Complications:

If untreated, typhoid fever can lead to severe complications, including:

1. Intestinal Perforation: A life-threatening condition where the intestinal wall develops holes, leading to peritonitis.
2. Severe Dehydration: Due to prolonged diarrhea or vomiting.
3. Sepsis: The bacteria can spread to other organs, leading to a widespread, potentially fatal infection.
4. Neurological Issues: Delirium, confusion, and even coma can occur in severe cases.

Diagnosis:

1. Blood Culture: The most definitive test, especially in the early stages of infection.
2. Stool and Urine Culture: Can help identify the bacteria in later stages.
3. Widal Test: A serological test that detects antibodies against Salmonella Typhi, though it is not as reliable as a culture.
4. Complete Blood Count (CBC): May show a decrease in white blood cells (leukopenia), which is common in typhoid fever.

Treatment:

1. Antibiotics:

• Common antibiotics include ciprofloxacin, azithromycin, and ceftriaxone.
• Multidrug-resistant (MDR) typhoid strains are becoming more common, so appropriate antibiotic choice is essential.

1. Hydration: Maintaining adequate fluid intake is crucial to prevent dehydration.
2. Rest: Ensuring proper rest allows the body to recover.

Prevention:

1. Vaccination:

• There are two main types of typhoid vaccines: the injectable (inactivated) and oral (live, attenuated) vaccines. These offer some protection but are not 100% effective.
• Vaccination is recommended for people traveling to areas where typhoid is endemic.

1. Safe Drinking Water: Ensuring access to clean, purified water is critical.
2. Good Hygiene: Proper handwashing, especially before eating or preparing food, can prevent the spread of the bacteria.
3. Avoid High-Risk Foods: Avoiding street food, unpeeled fruits, raw vegetables, and untreated water in regions where typhoid is common.

Prognosis:

With timely antibiotic treatment, most patients recover fully from typhoid fever. Without treatment, the illness can persist for weeks or months, leading to a higher risk of complications and death.