Rash, typhoid fever

Typhoid fever is caused by Salmonella typhii bacilli. The condition has an incubation period of about 5-23 days. Classic symptoms of typhoid fever include headache, abdominal pain with constipation or diarrhoea. Rose-coloured spots and macular rashes on the abdomen are characteristic of typhoid fever. 

Salmonella enterica (S. enterica) is a rod-shaped Gram-negative facultative anaerobe and a prominent enteric bacterial pathogen capable of causing food- and water-related diseases. Several serovars of S. enterica are associated with human infection. The principle clinical diseases associated with Salmonella infection are typhoid fever and gastroenteritis. S. enterica serovars Typhi S. Typhi) and Paratyphi (,S. Paratyphi) are pathogenically exclusive for humans and are known to cause typhoid or enteric fever (Ohl and Miller, 2001). Typhoid fever is a systemic infection characterized by the development of fever, abdominal pain, enterocolitis, and occasionally, a maculopapular rash. The hallmark feature of typhoid fever is the presence of mononuclear cell infiltration and hypertrophy of the intestinal Peyer s patches and mesenteric lymphoidal tissue (Kraus et al., 1999 Ohl and Miller, 2001). There are approximately 20 million cases of typhoid fever worldwide each year, and this acute and often life-threatening infection is responsible for over 200,000 deaths annually (Crump et al., 2004). 

Hypersensitivity Reactions Rashes may result from chloramphenicol hypersensitivity. Fever may appear simultaneously or be the sole manifestation. Angioedema is a rare complication. Jaiisch-Herxheimer reactions may occur after institution of chloramphenicol therapy for syphUis, brucellosis, and typhoid fever. 

Ofloxacin 200 mg twice daily to treat typhoid fever was well tolerated. Ten percent of treated subjects developed nausea and vomiting and one patient developed a skin rash [63 ]. Whether this was related to the underlying disease or the treatment is unclear. 

He also developed a fever of high grade associated with rigors. Later, he developed diarrhea and vomiting with general weakness and oral sores. (Sister reports that he developed the skin rash before the onset of all these symptoms.) He was admitted and treated for Typhoid. He improved. Given Nystatin ointment for oral sores, chloramphenicol and Septra. Discharged and stayed home for six months. 

The oral typhoid vaccine is well tolerated, with rare reports of gastrointestinal discomfort, fever, headache, or rash. Local injection-site reactions are the most commonly reported adverse event following the injectable typhoid vaccine (ViCPS). Systemic symptoms, such as fever, flufike symptoms, gastrointestinal discomfort, tremor, or neck pain, are reported occasionally. Most vaccinees will report injection-site reactions after the injectable Typhoid Vaccine USP. Malaise, headache, muscle aches, and fever also may occur. Very rarely, serious adverse events, such as chest paint, hypotension, and shock, have been reported. 

Typhoid, caused by S. typhi infection, presents as a high stepwise fever associated with bacteraemia and development of the pathognomonic signs of a truncal rash with salmon-coloured maculopapular lesions after around 1 week. Typical symptoms also include myalgias, abdominal pain and constipation. 

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