Typhoid

Question 1

What organisms cause Enteric fever (Typhoid/Paratyphoid)?

Answer 1

Typhoid is caused by Salmonella typhi, and Paratyphoid is caused by Salmonella paratyphi (types A, B, & C).

Question 2

How is Enteric fever (Typhoid/Paratyphoid) transmitted?

Answer 2

Typhoid and Paratyphoid are transmitted via the faecal-oral route, often through contaminated food and water.

Question 3

What are the key clinical features of Enteric fever (Typhoid/Paratyphoid)?

Answer 3

• Systemic upset (e.g., fever, headache, arthralgia)
• Relative bradycardia
• Abdominal pain and distension
• Constipation (more common than diarrhoea in typhoid)
• Rose spots (present on the trunk in 40% of patients, more common in Paratyphoid)

Question 4

What is the most common initial symptom of Enteric fever (Typhoid/Paratyphoid)?

Answer 4

The most common initial symptoms are fever, headache, and arthralgia (joint pain).

Question 5

What are rose spots, and in which type of Enteric fever are they more common?

Answer 5

Rose spots are small, raised, red or pink spots that appear on the trunk in about 40% of patients, and they are more common in Paratyphoid.

Question 6

What complications can arise from Enteric fever (Typhoid/Paratyphoid)?

Answer 6

• Osteomyelitis (especially in sickle cell disease)
• GI bleed/perforation
• Meningitis
• Cholecystitis (gallbladder inflammation)
• Chronic carriage (in about 1% of cases, more likely in adult females)

Question 7

Which groups are more likely to develop chronic carriage of Enteric fever (Typhoid/Paratyphoid)?

Answer 7

Chronic carriage is more likely in adult females, occurring in about 1% of cases.