Typhoid fever

What is Typhoid Fever?
Typhoid is a systemic bacterial infection caused by Salmonella typhi. It spreads through contaminated food and water.

Key Characteristic: Unlike a standard stomach bug, Typhoid causes a high, sustained fever ("Step-Ladder Fever") that rises daily, along with severe weakness and abdominal pain.

The 4 Stages of Typhoid

Symptoms usually appear 1–3 weeks after exposure. They progress slowly if untreated.

Week 1: The Onset

• Step-Ladder Fever: Starts low and rises daily, reaching 103–104°F (39–40°C).
• Headache & Dry Cough.
• Weakness: Extreme fatigue and muscle aches.
• Abdominal Pain: With either constipation (adults) or diarrhea (children).

Week 2: The Rash & Pain

• Rose Spots: Small, flat, pink spots may appear on the lower chest/abdomen.
• Distended Abdomen: The stomach looks swollen and feels painful.
• High Fever: Remains high and does not fluctuate much.

Week 3: The Danger Zone

If still untreated, this is the most critical week.

• "Typhoid State": Lying motionless, half-asleep, and delirious.
• Complications: Risk of intestinal bleeding or perforation.

Week 4: Recovery

The fever begins to drop gradually. Full recovery can take weeks.

⚠️ EMERGENCY: INTESTINAL PERFORATION
In the 3rd week, ulcers in the intestine can burst. This is life-threatening.
Seek immediate surgery if:

• Sudden, excruciating stomach pain.
• Rapid drop in blood pressure (Shock).
• Blood in the stool (tarry/black stool).

Transmission: The F-Diagram

Typhoid spreads via the Fecal-Oral Route. This happens through:

Fluids	Drinking contaminated water or milk.
Food	Eating raw vegetables washed in dirty water or food handled by infected persons.
Fingers	Not washing hands after using the toilet.
Flies	Flies transfer bacteria from feces to food.

Diagnosis

Doctors look for the bacteria in your system. Be aware of the testing differences:

• Blood Culture (Gold Standard): The most accurate test in the first week.
• Widal Test: A common older test. Note: It often gives false positives, so do not rely on this alone without a doctor's interpretation.
• Stool Culture: Useful in the 2nd or 3rd week.

Treatment

Typhoid is treated with antibiotics. You will usually feel better within 2–3 days of starting medication.

• Antibiotics: Ciprofloxacin, Ceftriaxone, or Azithromycin.
• Fluids: IV fluids may be needed for severe dehydration.

Warning on Resistance: Multi-Drug Resistant (MDR) Typhoid is becoming common. You must finish your full course of antibiotics even if your fever breaks, to prevent the bacteria from returning stronger.

The Typhoid Diet

Your intestine is inflamed and fragile. Eat soft, easily digestible foods.

🍽️ WHAT TO EAT vs. AVOID

• EAT: Yogurt, boiled potatoes, porridge, white rice, coconut water, bananas, boiled eggs.
• AVOID: Spicy food, high-fiber foods (whole grains, raw salads), fried items, and milk (if it causes bloating).

Prevention & Carriers

• Vaccination: Available as an injection or oral capsule. Recommended for travelers to endemic areas (Asia, Africa, Latin America).
• Chronic Carriers: Some people recover but still carry the bacteria in their gallbladder (like "Typhoid Mary"). They shed bacteria in their stool for years. If you have a history of Typhoid, wash hands rigorously before cooking for others.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.