Not to be confused with typhus, which presents with similar symptoms.
Typhoid fever is a bacterial disease caused by the salmonella bacteria. It is transmitted by ingesting the bacteria in contaminated food or stool. Once common everywhere, it is now almost unknown in areas with good sanitation, although it is still a problem in the developing world.
Typhoid first presents with a one week period with a slowly increasing fever with bradycardia, headache, malaise and cough. The disease cannot be detected in blood cultures at this point. In the second week, patients suffer from a fever of 104F (40C) and delerium. The abdomen becomes enlarged and painful, as do the spleen and liver. In the third week, complications can develop including intestinal bleeding, intestinal perforation, encephalitis, cholecystitis and endocarditis. Dehydration becomes a risk. After the third week, the fever starts to subside and the patient usually recovers.
Rehydration is the treatment of choice and many patients do not require other treatment. Antibiotics should be administered as soon as typhoid is suspected, but many strains of salmonella are antibiotic resistant. Surgery may be necessary to repair bleeding or perforated organs.