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Typhoid Fever - Causes, Symptoms and Treatment
Written By : Dr. James Pendergraft 
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Typhoid Fever is a serious and potentially fatal illness which is caused by a bacterial infection. This disease is primarily associated with poor hygiene and is more common in areas with poor sanitation.


Typhoid Fever is caused by the bacteria species known as Salmonella enterica. These bacteria are transmitted into the victim through contaminated water in most cases of infection. If the water or even food contaminated with fecal wastes from an infected person is consumed by a person, he or she could get infected with the typhoid bacteria found in the feces.

Once the bacteria enter into the body through the digestive tract, they penetrate into the intestinal walls and are phagocytosed, or engulfed in solid form by macrophages which are a type of white blood cells. From there, it is taken into parts of the body where it can multiply like spleen, liver and bone marrow. Once it multiplies in good numbers, it enters the blood stream again causing symptoms of the fever.

Not everyone may get critically ill after the bacteria infect them. People developing mild fever which can be overlooked can actually go on to be long term carriers of the disease, as the bacteria find havens to multiply in the liver, gall bladder and bile duct.


The symptoms of Typhoid Fever include the following.

· Slowly progressive high fever
· A very high fever degree of 104 °F
· Red colored, flat rash or spots
· Poor appetite
· Headache
· Fatigue
· Diarrhea

However, the disease progresses through no less than four stages spanning across a little more than three weeks. In the first week, the fever, headache and cough attack the patient with malaise. It may also accompany nose bleeding and abdominal pain. In the second week, the fever reaches up to 104 °F, marked by low heartbeat rate and a dicrotic pulse. Delirium is a noted symptom during this stage. Diarrhea and constipation are experienced frequently by victims.

The third stage can be particularly dangerous due to the risks of development of certain complications such as intestinal hemorrhage, muttering delirium and the intestinal perforation could occur. The fever gradually reduces by the end of the third week.


The diagnosis of the typhoid fever is carried out by testing blood samples, bone marrow and stool cultures to check for the presence of the Salmonella type bacteria through the Widal Test, which confirms the presence of the antibodies for the parasite. However, the test can take a bit too long to confirm the results, as timely antibiotic treatment is vital to the treatment of the disease. Till the results from the Widal Test are awaited, ciprofloxacin is administered.


Even though typhoid has been known to be potentially fatal and dangerous, it does not result in death most of the time. It is important to note that immediate treatment should be offered to the victim of typhoid fever which could help reduce the risk of fatality due to the disease to a mere 1%. Recovery is about a little more than a week. However, in case the victim is not treated, the fever will last a complete three weeks and could result in deaths in some cases.

One of the most widely used treatments of typhoid fever is administering antibiotics to the victim, particularly ciprofloxacin, amoxicillin, ampicillin and chloramphenicol, which are aimed to kill the Salmonella bacteria in the body. Chloramphenicol has been the primary drug of choice for the treatment, but other drugs such as ciprofloxacin, ampicillin and trimethoprim-sulfmethoxazole are usually prescribed due to effectiveness and milder side effects.

As the sanitation conditions improve around the world, the occurrence of the disease is becoming less common as well. However, you should remain careful while traveling to a particular region where you know that typhoid is common and get vaccinated before doing so.

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