Etiology
The main causative agent of typhoid fever is Salmonella typhi and Salmonella paratyphi, both members of the Enterobacteriaceae family. Salmonella is transmitted by the fecal-oral route through contaminated water, undercooked food, fomites from infected patients.
epidemiology
The incidence of typhoid fever is more common in low- and middle-income countries in Central and South Asia and southern Africa than in developed countries. Most cases in developed countries are transmitted by travelers returning from endemic areas and travelers visiting family and friends who are at higher risk due to their likelihood of being less cautious with food and water sources.
Pathophysiology
The pathogenesis of typhoid fever depends on several factors, including infectious species, virulence, host immunity, and infectious dose. The higher the infectious dose, the shorter the incubation period and the higher the attack rate.
Treatment / Management
Antibiotic therapy is the mainstay of treatment. The treatment has been complicated by multi-drug resistance strains developed in many endemic areas, especially in India and Southeast Asia. The treatment modality depends on the severity of the disease, the duration, the spread, and the complications.
Differential diagnosis
Typhoid fever has nonspecific manifestations. It can resemble multiple infectious diseases with similar clinical presentations. Therefore, a broad differential diagnosis should be considered. Illnesses with symptoms including diarrhea, dysentery, abdominal distension, fever, splenomegaly, and shock should be considered in the correct clinical setting.
Dr. Roberto Valdes Charles
Est Med Ethel Elizabeth Lule Rivera
