Typhoid fever is an acute infectious disease caused by salmonella (Salmonella typhi) and characterized by fever, symptoms of general intoxication, bacteremia, enlargement of liver and spleen, enteritis and morphological changes in the lymph nodes of the intestine. Typhoid fever is caused by Salmonella enterica serovar Typhi from the family Enterobacteriaceae genus Salmonella. Salmonella is a gram-negative bacillus that produces endotoxin which is pathogenic only for human-beings.
The mechanism of transmission of pathogens is fecal-oral meaning that infection occurs when people use contaminated water or food. Food or water transmission S. typhi are rarely observed, mainly among children.
The incubation period is from 7 days to 23 days, characterized by the formation of solitary follicles, bacteremia, intoxication syndrome.
The initial period lasts 4-7 days and characterized by strengthening the symptoms of intoxication. Pale skin, weakness, headache, decreased appetite, bradycardia, coated tongue with white coating, constipation, flatulence, diarrhea are the most common symptoms for initial period.
Main phase lasts 9-10 days and characterized by continuously high temperature, expressed symptoms of intoxication, skin rash on the stomach, breast, extremeties, changes of heart tones, bradycardia, hypotension. Tongue is coated, patients complain on abdominal distension, tendency to constipation, enlargement of liver and spleen. In severe cases patients may experience hallucinations, confusion, mental retardation.
Period of recovery is characterized by decreased intoxication, appetite occurance, sleep normalization, improvement of general feeling. Nearly 3-10% of patients may experience relapses during re-convalescence period.