Typhoid and Paratyphoid fever

Typhoid and Paratyphoid fever

ICD-10 A01.0: Typhoid Fever
ICD-10 A01.1-A01.4: Paratyphoid Fever
Identification

A systemic bacterial disease with insidious onset of sustained fever, severe headache, malaise, anorexia, relative bradycardia, nonproductive cough in early stage of illness, rose spots on the trunk and constipation more often than diarrhea in adults. Intestinal hemorrhage or perforation can occur in 1% of cases. Case fatality rate is 10%-20% without antibiotic therapy and 1% with antibiotic use. Relapse may occur in 15%-20% of patients, but with milder form.

Paratyphoid fever presents a similar clinical picture, but tends to be milder, and the case-fatality rate is much lower.

Case classification:
• Suspected case: Any case having the following features: sustained, non-sweating fever of 38 oC or more, for 3 days or more, abdominal discomfort (abdominal pain, diarrhea or constipation). With 2 or more of the following symptoms: dry non-productive cough, relative bradycardia, anorexia, severe headache.
• Confirmed Case: A suspect or probable case with detection of S. typhi or S. paratyphi through positive culture of blood, stool, urine or bone marrow (laboratory investigation: culture of blood early in the disease; stool and urine after the first week; or bone marrow culture which provide the best bacteriologic confirmation (90%-95% recovery) even in patients who have already received antimicrobials. Because of its limited sensitivity and specificity, serologic tests (widal test) are generally of little diagnostic value
stool, urine or bone marrow (laboratory investigation: culture of blood early in the disease; stool and urine after the first week; or bone marrow culture which provide the best bacteriologic confirmation (90%-95% recovery) even in patients who have already received antimicrobials. Because of its limited sensitivity and specificity, serologic tests (widal test) are generally of little diagnostic value

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