typhoid (enteric) fever

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Etiology

Epidemiology

  • most cases can be traced to a human carrier
  • 500 cases annually
  • median age of patients 24 years
  • Mexico is primary reservoir for USA
  • risk of clinical typhoid increased 25-fold in HIV patients
  • 1 in 3000 unimmunized travelers to developing countries infected
  • infectivity may persist for 15 years[9]
  • travelers returning for Southeast Asia[10]
  • extensively drug-resistant Salmonella typhi among travelers to or from Pakistan 2016-2018[11]
  • from February 2018 to November 2020, 71 cases of extensively drug-resistant Salmoniella typhi infection were reported in the U.S
    • 87% reported travel in Pakistan within 30 days prior to symptom onset
    • 13% denied a travel history[12]

Pathology

Clinical manifestations

Laboratory

Complications

Differential diagnosis

Management

More general terms

Additional terms

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 672
  2. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 951-54
  3. Prescriber's Letter 9(7):40 2002
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018, 2021.
  5. 5.0 5.1 5.2 5.3 Meltzer E, Schwartz E. Enteric fever: a travel medicine oriented view. Curr Opin Infect Dis. 2010 Oct;23(5):432-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20613510
  6. Steinberg EB, Bishop R, Haber P et al Typhoid fever in travelers: who should be targeted for prevention? Clin Infect Dis. 2004 Jul 15;39(2):186-91. Epub 2004 Jul 1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15307027
  7. 7.0 7.1 National Antimicrobial Resistance Monitoring System The 2012 NARMS Annual Human Isolates Report CDC NARMS tracks antimicrobial resistance in Salmonella and other enteric (intestinal) bacteria that may cause mild or severe diarrhea or bloodstream infection. http://www.cdc.gov/narms/reports/annual-human-isolates-report-2012.html
  8. Waddington CS, Darton TC, Pollard AJ. The challenge of enteric fever. J Infect. 2014 Jan;68 Suppl 1:S38-50. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24119827
  9. 9.0 9.1 Hancock-Allen J, Cronquist AB, Peden J et al Notes from the Field: Typhoid Fever Outbreak Associated with an Asymptomatic Carrier at a Restaurant - Weld County, Colorado, 2015. MMWR Morb Mortal Wkly Rep 2016;65:606-607 http://www.cdc.gov/mmwr/volumes/65/wr/mm6523a4.htm
  10. 10.0 10.1 10.2 10.3 10.4 10.5 10.6 Rothaus C Home Sweet Home. NEJM Resident 360. Jan 31, 2018 https://resident360.nejm.org/content_items/home-sweet-home
  11. 11.0 11.1 Chatham-Stephens K, Medalla F, Hughes M, et al. Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan - United States, 2016-2018. MMWR Morb Mortal Wkly Rep 2019;68:11-13 https://www.cdc.gov/mmwr/volumes/68/wr/mm6801a3.htm
  12. 12.0 12.1 12.2 12.3 Harrison L CDC Warns of Drug-Resistant Typhoid Fever Outbreak Medscape - Feb 17, 2021. https://www.medscape.com/viewarticle/945986
    Centers for Disease Control & Prevention (CDC) Extensively Drug-Resistant Salmonella Typhi Infections Among U.S. Residents Without International Travel. CDC Health Alert Network. Feb 12, 2021 https://emergency.cdc.gov/han/2021/han00439.asp