A new study published in StatPearls discussed that typhoid fever – an enteric fever caused by Salmonella typhi, is characterized by systemic illness along with abdominal pain and fever in a "step-ladder" pattern. Other serotypes like Salmonella paratyphi (A, B, C), also cause similar syndromes with milder clinical manifestations. 

The present article reviewed the evaluation and management of typhoid fever and the role of interprofessional team in improving care of patients. For typhoid diagnosis, blood culture, stool culture, bone marrow culture and widal test are utilized. Other tests are punch biopsies, PCR assay, ELISA and urine culture. Antibiotic therapy is the mainstay of treatment in typhoid. Culture and susceptibility are assessed before choosing an antimicrobial therapy. Fluoroquinolones are generally used and can be administered empirically on clinical suspicion. In multi-drug-resistant 

(MDR) cases, third-generation cephalosporins – ceftriaxone, cefotaxime and oral cefixime, and azithromycin can be chosen with ciprofloxacin as an alternative treatment.

In addition, symptomatic and supportive care is essential. Maintaining adequate hydration as well as appropriate ventilation and oxygenation for pulmonary complications are essential. Furthermore, analgesics and antipyretics should be provided as supportive care for metastatic complications. Meanwhile, corticosteroids can be used in severe cases with encephalitis.

The article summarized that typhoid fever persists to be a significant cause of morbidity and mortality worldwide. Intersectoral coordination by authorities in sanitation management, public healthcare awareness, and nutritional programs can aid in the control and prevention of disease. The emergence of drug-resistant Salmonella typhi has increased the public health burden due to this disease. Early identification and diagnosis, specific antimicrobial treatment and appropriate antibiotic course are necessary to prevent complications.

Source: In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.