One of 2 Gram negative bacilli:
- Samonella typhi
- Samonella paratyphi (paratyphoid fever - a less aggressive illness but clinically indistingishable)
- Abdominal pain
- Slight abdominal distension
- Hepatosplenomegaly (neither/either/both)
- "Septic" - tachycardic, tachypnoeic
- FBC - leucocytosis
- U+Es - often mild hyponatraemia and hypokalaemia
- LFTs - deranged (predominately transaminases)
- Blood cultures
- Stool (frequently positive)
- AXR if indicated by examination
- Abdominal ultrasound to investigate LFTs (also excludes perforation if no free fluid)
Ciprofloxacin is currently standard, although there are increasing concerns about resistance. Extended-spectrum βlactmase producing strains exist, and many are now resistent to co-trimoxazole, ampicillin and chloramphenicol.
Antipyretics, intravenous fluids and analgesia
If complications arise, eg perforation
- Exclusion of food handlers is essential, and needs to be prolonged. Their contacts also need to be excluded until screened. See enteric pathogens article for more details.
- Current vaccines not suitable for young children
- Typhoid conjugate vaccines (TCVs) are in advanced development (eg Typbar-TCV, Vi-TT, Vi-PS). These vaccines have about 50% efficiency at 1 month after single inoculation.
This article is a stub. Please feel free to expand it and make it more encyclopaedic.