TYPHOID FEVER: Diagnosis And Treatment

- December 07, 2020
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The diagnosis

Medical and travel history

Your doctor will likely suspect typhoid fever based on your symptoms, medical and travel history. The diagnosis is usually confirmed by identifying Salmonella typhi in a culture of blood or other body fluids or tissues.

Body fluids or tissue culture

For culture, a small sample of blood, stool, urine, or bone marrow is placed on a special medium that encourages bacterial growth. The culture is examined under a microscope for typhoid bacteria. A bone marrow transplant is often the most sensitive test for Salmonella typhi.

Although the culture test is the most common diagnostic test, other tests may be used to confirm a typhoid fever infection, such as a test to detect antibodies to typhoid bacteria in the blood or a test that checks the typhoid DNA in the blood.

Treatment

Antibiotic treatment is the only effective treatment for typhoid fever.


Commonly prescribed antibiotics

Commonly prescribed antibiotics include:


Ciprofloxacin (Cipro). In the United States, doctors prescribe this drug to adults who are not pregnant. Another similar medicine called ofloxacin may also be used. Unfortunately, many Salmonella typhi bacteria are no longer susceptible to antibiotics of this type, especially the strains caught in Southeast Asia.

Azithromycin (Zithromax). This may be used if the person is unable to take ciprofloxacin or the bacteria are resistant to ciprofloxacin.

Ceftriaxone. This injectable antibiotic is an alternative for more complex or serious infections and for people who may not be candidates for ciprofloxacin, such as children.

These medications can cause side effects, and their long-term use can lead to the development of antibiotic-resistant bacteria.


Problems with antibiotic resistance

In the past, the drug of choice was chloramphenicol. It is no longer commonly used by doctors due to side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance.

In fact, antibiotic-resistant bacteria are becoming more and more common, especially in the developing world. In recent years, Salmonella typhi has also proven resistant to trimethoprim - sulfamethoxazole, ampicillin and ciprofloxacin.

Other treatments

Other treatments include:

Drinking fluids. This helps prevent dehydration caused by prolonged fever and diarrhea. If you are severely dehydrated, you may need to receive fluids intravenously (intravenously).

surgery. If your intestine is torn, you will need surgery to repair the hole.

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Preparing for your appointment

Call your doctor if you have recently returned from traveling abroad and develop mild symptoms similar to those that occur with typhoid fever. If your symptoms are severe, go to the emergency room or call 911 or your local emergency number.

Here's some information to help you get ready and know what to expect from your doctor.

Information to be collected in advance

Pre-appointment restrictions. At the time you make your appointment, ask if there are restrictions you need to follow in the time leading up to your visit. Your doctor will not be able to confirm typhoid fever without a blood test, and may recommend that you take steps to reduce the risk of transmitting a potential infectious disease to others.

History of symptoms. Write down any symptoms you've been experiencing and for how long.

Recent exposure to potential sources of infection. Be prepared to describe international trips in detail, including the countries you have visited and your travel dates.

Medical history. List your key medical information, including other conditions you're being treated for and any medications, vitamins or supplements that you're taking. Your doctor will also need to know your vaccination history.

Questions to ask your doctor. Write down your questions in advance so that you can make the most of your time with your doctor.

For typhoid fever, questions to ask your doctor include:

What are the possible causes of my symptoms?

What kinds of tests do I need?

Are treatments available to help me recover?

I have other health problems. How can I best manage these conditions together?

How long do you expect a full recovery to take?

When can I return to work or school?

Am I at risk of long-term complications from typhoid fever?

Feel free to ask any other relevant questions you may have.


What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may give you time to discuss any points you want to talk in depth. Your doctor may ask:

What are your symptoms and when did they start?

Have your symptoms improved or worse?

Did your symptoms briefly improve and then return?

Have you recently traveled abroad? Where?

Did you update your vaccinations before traveling?

Are you being treated for any other medical conditions?

Are any medications currently underway?

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