TYPHOID/ENTERIC FEVER - Pedia

Potentially fatal multisystemic disease characterized by fever and abdominal

pain and caused by dissemination of S. typhi or S. paratyphi

EPIDEMIOLOGY
 Asia
 Highest in children younger than 5 yr of age
 Human: only host

ETIOLOGY/ RISK FACTORS

 S. enterica serovar Typhi (S. typhi)
 Less severe: Salmonella paratyphi A, B (Schotmulleri), C
(Hirschfeldii)
 Fecal-oral transmission
 Infective dose: 105-109 organisms DIFFERENCTIAL DIAGNOSES (3)
 Incubation period: 7-14 days to 3-30 days, depending on the  Malaria
inoculum size  Acute gastroeneteritis
 Direct or indirect contact with an infected person (sick or chronic  Dengue fever
carrier): prerequisite for infection.
 MC MOT: Ingestion of foods or water contaminated with S. Typhi DIAGNOSIS
from human feces
 Waterborne outbreaks: 2’ to poor sanitation or contamination
 Oysters and other shellfish cultivated in water contaminated by
sewage
 Night soil as fertilizer

SALIENT FEATURES
 High-grade fever with a wide variety of associated features, such as
generalized myalgia, abdominal pain, hepatosplenomegaly, and
anorexia
 Fever may rise gradually; classic stepladder rise of fever is rare MANAGEMENT
 Rose spots (maculopapular rash) -7th -10th day of illness  Adequate rest, hydration; correct fluid and electrolyte imbalance.
 Coated tongue, diarrhea, pallor, constipation, headac, jaundice,  Antipyretic therapy (acetaminophen 10-15 mg/kg every 4-6 hr PO)
obtundation, ileus, intestinal perforation  A soft, easily digestible
 Diet - continued unless with abdominal distention or ileus