Typhoid

Last updated: Thursday, 17, February, 2011
Key InformationAppropriate Tests

Blood culture, faeces – microscopy, culture and antigen detection. Urine microscopy and culture. 

A similar syndrome may be caused by Salmonella paratyphi, which can be distinguished from S. typhi on culture.

Culture of pus of specimen from local sites of infection (e.g. bone marrow, lymph node) if diagnosis has not been established on culture of blood, faeces and urine. FBC, blood film.

Typhoid antibodies (Widal test) are of only limited value as both false negative and positive results are common.

Presentation

Fever

Headache

Rose spots

Hepatomegaly

Splenomegaly

Lymphadenopathy (cervical)

Anaemia

Neutropenia

See Pyrexia of unknown origin

Complications

Intestinal haemorrhage

Intestinal perforation

Osteomyelitis

Endocarditis

Myocarditis - toxic

Relapse

Relapse occurs in approximately 10% of treated patients: documentation is by repeat cultures before immediate treatment.

Asymptomatic carrier state

Faeces microscopy, culture and antigen detection (repeated culture may be required).