Typhoid fever

Diagnosis

Diagnosing typhoid fever entails a comprehensive process that includes symptom assessment, review of travel history, physical examination, and the administration of various diagnostic tests.

Tests that may be required include:

• Tissue or body fluids test: A healthcare provider might collect various body fluid or tissue samples to check for S. Typhi, the bacterium responsible for typhoid fever. If the bacteria that cause typhoid fever are present, they will multiply and can be seen under a microscope. A culture test where a sample of the blood, stool, urine, or bone marrow is often used. Bone marrow culture is the most accurate among these.
• Imaging tests: X-rays may be required to examine the lungs for any unusual changes.

Treatment

Typically, typhoid fever is managed with antibiotics, complemented by interventions to prevent dehydration and manage any complications that may arise. Adequate fluid intake is essential to maintain hydration, with intravenous fluids necessary in cases of severe dehydration. In instances where the illness results in intestinal damage, surgical intervention may be necessary to address the issue. Antibiotic resistance among some bacterial strains underscores the importance of tailoring antibiotic treatment based on the individual’s location of infection and the specific type of typhoid contracted.

Frequently recommended antibiotics: Certain antibiotics affect strains differently depending on where they were acquired. Medications that may be prescribed in combination or alone include:

• Fluoroquinolones: Although some bacteria can withstand these drugs, which is known as antibiotic resistance, these are still effective in treating infections because they prevent bacteria from replicating. Fluoroquinolones, such as ciprofloxacin, are often the first antibiotics that are prescribed for treatment.
• Macrolides: Antibiotic resistance may be addressed with one type of medication called azithromycin. Antibiotics in this class prevent bacteria from producing proteins.
• Carbapenems: When treating severe infections that fail to improve with other antibiotics, this medication may be prescribed. These antibiotics stop bacteria from forming cell walls.
• Cephalosporins: Ceftriaxone, a type of antibiotic in this group, is often used when bacteria have become resistant to other antibiotics. This group of antibiotics works by stopping bacteria from making cell walls, which are crucial for their survival.