Typhoid and Paratyphoid

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Description

It is an acute systemic disease resulting from infection by Salmonella typhi and S. paratyphi, serovar group A and B respectively. Infection is acquired through ingestion of contaminated food and water.

Signs and Symptoms

  • Fever
  • Severe headache
  • Abdominal pain
  • Muscle pains (myalgia)
  • Obtundation
  • Intestinal haemorrhage
  • Bowel perforation
  • Sequela neuropsychiatric complications

Investigations

  • Evidence of positive cultures from bone marrow aspirates; blood or stool done within 1 week of acute infection OR
  • Serological evidence of rising high titers above 1:160 (Widal test), OR
  • Indirect fluorescent Vi antibody
  • ELISA for immunoglobulin M (IgM) and IgG antibodies to Typhi polysaccharide.

Treatment

  • Ciprofloxacin 500mg (PO) OR 400mg (IV) 12 hourly for 10-14 days

        OR

  • Azithromycin (PO) Adult 500mg for 7 days

        OR

  • Ceftriaxone 2g once daily for 10-14days