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INFECTIOUS DISEASE

TYPHOID - SALMONELLA TYPHI

Typhoid Fever:
Infection of the intestinal system caused by the bacterium salmonella typhi. Causes genearlised weakness, headache, fever, rash (Rose spots- pathognomonic)- chest/abdo, chills, severe causes splenomegaly, inflammation of bones and GI lining >> haemorrhage, delirium. Spread food or drinking water contaminated by infected faeces/urine. - oxford

Note: not to be confused with “Typhus” (spotted fever) which is a rickettsial infection.

2015 - Denguvaxia - can be given if had dengue before
2022 - Qdenga - can be given to anyone (?not approved in Aus)
PromptTransmission of Typhoid
ResponseFoecal-oral route
Requires isolation as stools may shed
Self-rate:
PromptTyphoid specific history
ResponseImmunisation status/pre travel vaccination
Occupation - child care worker, food handling
Holiday history - location, high risk activities, diet, mosquito bites, sick contacts
Symptoms - Fever, night sweats, stools, bleeding/patechiae etc.
Self-rate:
PromptMost useful investigations
ResponseBlood flim - Microcytic anaemia + thrombocytopaenia
Cultures - Stool/blood/urine
Malaria/dengue
CXR
Self-rate:
PromptTreatment - Typhoid
ResponseSystemic treatment: (eg. if positive blood cultures)
  • IV ceftriaxone 2g OD
  • OR IV ciprofloxacin 400 mg BD
Oral treatment
  • Azithromycin 1g then 500 mg daily x 7/7 total
  • Ciprofloxacin 500 mg BD x 5-7 days
Mandatory notification
Supportive care
Self-rate:
PromptComplications of salmonella infection
ResponseIleal perforation due to inflammation of “peyers patch” - Surgery + surgical tripple abx
Relapse of typhoid fever (2-3 wks) - needs more abx
Chronic carriage - in stool for up to 12 months!
Rare but serious: Encephalopathy, psychosis, septic arthritis/OM/DVT, Haemolysis, DIC
Self-rate:
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