Typhoid Fever

Question 1

Any individual who lives in or who has history of travel from tropical and subtropical areas; who presents with fever of
> 5 days of fever; fever documented at > 38*c WITH any of the following symptoms: headache, diarrhea, body malaise/ weakness, abdominal distention/pain, gastrointestinal bleeding and changes in orientation/ confusion

Answer 1

should be considered a suspected typhoid fever case (strong recommendation,high quality of evidence)

Question 2

Direct Detection Method

Answer 2

Culture and Isolation(strong recommendation,
high quality of evidence)

Polymerase chain reaction (conditional recommendation, moderate quality of evidence)

Question 3

Indirect Method

Answer 3

Antibody detection
 (conditional recommendation, high quality of evidence) 
- Tubex
- Typhidot
- TyphiRapid

Question 4

True or false:

The Widal test is NO LONGER RECOMMENDED FOR DIAGNOSIS OF TYPHOID FEVER (Strong recommendation, high quality of evidenc

Answer 4

True

Question 5

Empiric treatment for suspected MDRTF

Strong recommendation, Moderate quality of evidence

Answer 5

Cefixime 200mg/tab 1 tab q12h
Ciprofloxacin 500mg/tab 1 tab q12h Ofloxacin 400mg/tab 1 tab q12h
Azithromycin 500mg/tab 1-2 tab q24 hr

Question 6

Treatment for Chronic Carriers

Strong recommendation, Moderate quality of evidence

Answer 6

6-12 weeks of
TMP-SMX 800/160 1 tab q12h
Amoxicillin 100mg/kg/day
Ampicillin 100mg/kg/day

4 weeks of
Norfloxacin 400mg 1 tab q12h
Ciprofloxacin 750 1 tab q12h

Question 7

Summary of Recommended Antibiotics for Uncomplicated Typhoid Fever
(Strong recommendation, High quality of evidence)

Answer 7

Amoxicillin
Chloramphenicol
TMP SMX