Typhoid Fever

Douglas W. MacPherson, MD, MSc–CTM, FRCPC Reviewed 06/2019

BASICS

A common enteric bacterial disease transmitted by ingestion of contaminated food or water
Most cases in the United States are imported from endemic areas of South or Southeast Asia and Latin Ame...

DIAGNOSIS

Assess clinical presentation and exposure history, including travel and exposures to S. typhi carriers.

HISTORY

Travel history to an endemic region and exposure to contaminated food or water
E...

TREATMENT

Treatment of typhoid disease and chronic carrier states must be determined on an individual basis. Factors to consider include age, public health and occupational health risk (e.g., food han...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Bed rest initially and then activity as tolerated

Patient Monitoring

See “General Measures.”

DIET

NPO if abdominal symptoms are severe. With improvement, begin norm...

REFERENCES

Jackson BR, Iqbal S, Mahon B; for Centers for Disease Control and Prevention. Updated recommendations for the use of typhoid vaccine—Advisory Committee on Immunization Practices, United St...

ADDITIONAL READING

Antillón M, Bilcke J, Paltiel AD, et al. Cost-effectiveness analysis of typhoid conjugate vaccines in five endemic low- and middle-income settings. Vaccine. 2017;35(27):3506–3...

CODES

ICD10

A01.00 Typhoid fever, unspecified
Z22.0 Carrier of typhoid
A01.03 Typhoid pneumonia
A01.09 Typhoid fever with other complications

ICD9

002.0 Typhoid fever
V02.1 Carrier or suspected carrier of ty...

CLINICAL PEARLS

Consider typhoid (along with malaria, dengue, and other travel-associated infections) in febrile travelers returning from endemic areas (Latin America, sub-Saharan Africa, South Asia).
...

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