Typhoid fever

Bacteria are smaller than protozoa and are responsible for many diseases, such as typhoid fever, cholera, diarrhea, and dysentery. Pathogenic bacteria range in size from 0.2 to 0.6 /tm, and a 0.2 /tm filter is necessary to prevent transmission. Contamination of water supplies by bacteria is blamed for the cholera epidemics, which devastate undeveloped countries from time to time. Even in the U.S., E. coli is frequently found to contaminated water supplies. Fortunately, E. coli is relatively harmless as pathogens go, and the problem isn t so much with E. coli found, but the fear that other bacteria may have contaminated the water as well. Never the less, dehydration from diarrhea caused by E. coli has resulted in fatalities. 

Chloramphenicol, a powerful antibiotic isolated in 1949 from the Streptomyces venezuelae bacterium, is active against a broad spectrum of bacterial infections and is particularly valuable against typhoid fever. Assign R,S configurations to the chirality centers in chloramphenicol. 

The award of a Beit Memorial Fellowship for medical research in 1933 provided him with more financial security and independence. Stacey moved to London and for the next 3 years worked full-time in Raistrick s laboratory. He was given the task of working on vaccines against typhoid fever. The work was successful eventually and the vaccines were used by the Royal Air Force and also were sent to the Air Force in New Zealand. Also, some advances were made in studies of the carbohydrate components of the vaccines. In addition to this research, he completed, by part-time study, the diploma course in bacteriology. 

Table II. Mortality for Typhoid Fever and Death Rates per 100,000 Population...

Salmonella typhi is the causal organism of typhoid fever, Sal. paratyphi causes paratyphoid fever, whilst Sal. typhimurium, Sal. enteritidis and very many other closely related organisms are a cause of bacterial food poisoning. 

The current drug of choice for typhoid fever is a fluoroquinolone, such as ciprofloxacin. The recommended dose of ciprofloxacin for uncomplicated typhoid is 500 mg orally twice daily for 5 to 7 days. Drug resistance is a recognized... 

The chronic carrier state, defined as positive stool or urine cultures for more than 12 months, develops in 1% to 4% of adults with typhoid fever. Persistence of the organism, in many cases, is due to billiary tract carriage, and the frequency of chronic carriage is higher in persons with biliary abnormalities. 

Patients with complicated typhoid fever (i.e., metastatic foci, ileal perforation, etc.) should receive parenteral therapy with ciprofloxacin 400 mg twice daily or ceftriaxone 2000 mg once daily. Antimicrobial therapy can be completed with an oral agent after initial control of the symptoms of typhoid fever. In persons with AIDS and a first episode of Salmonella bacteremia, a longer duration of antibiotic therapy (1-2 weeks of parenteral therapy followed by 4 weeks of oral fluoroquinolone) is recommended to prevent relapse of bacteremia. 

Suggested Alternatives for Differential Diagnosis Abdominal aneurysm, aortic dissection, pleural effusion, subarachnoid hemorrhage, superior vena cava syndrome, hantavirus pulmonary syndrome, mediastinitis, fulminate mediastinal tumors pneumonia, gastroenteritis, meningitis, ecthyma, rat bite fever, spider bite, leprosy, plague, tularemia, coccidioidomycosis, diphtheria, glanders, histoplasmosis, psittacosis, typhoid fever, and rickettsial pox. 

Suggested Alternatives for Differential Diagnosis Influenza, infectious mononucleosis, hepatitis, leptospirosis, infective endocarditis, malaria, tuberculosis, typhoid fever, cryptococcosis, histoplasmosis, ankylosing spondylitis and undifferentiated spondyloarthropathy, collagen vascular disease, chronic fatigue syndrome, malignancy, and osteomyelitis. 

Suggested Alternatives for Differential Diagnosis Brucellosis, chlamydial pneumonias, infective endocarditis, legionnaires disease, mycoplasma infections, pneumonia, Cox-iella burnetii infection, Francisella tularensis infection, Q fever, tuberculosis, tularemia, typhoid fever, and all atypical pneumonia. 

Suggested Alternatives for Differential Diagnosis Other causes of pneumonia, typhoid fever, tuberculosis, plague, anthrax infection, smallpox. 

Fact Sheet 149 Typhoid Fever. Geneva Health Communications and Public Relations, March... 

Suggested Alternatives for Differential Diagnosis Malaria, typhoid fever, shigellosis, meningococcemia, salmonella infection, other tick-borne diseases, rickettsial infections, leukemia, lupus, disseminated intravascular coagulation, hemolytic uremic syndrome, leptospirosis, thrombocytopenic purpura, and idiopathic or thrombotic thrombocytopenic purpura. 

Suggested Alternatives for Differential Diagnosis Other forms of encephalitis (e.g., California, Eastern Equine, St Louis, West Nile, Murray Valley), malaria, dengue fever, meningitis, tuberculosis, typhoid fever, enteroviruses, herpes simplex, and Nipah virus. 

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