Typhoid fever is an infection that spreads through contaminated food and water.Vaccines are recommended in areas where typhoid fever is common.
• Gradual onset of malaise, headache, sore throat, cough and finally pea-soup diarrhoea or consti- pation.
• Slow rise (Step-ladder) of fever to maximum and then gradual lowering down of fever is common with maximum temperature at evening hours (variation less than 2F). Temperature never becomes normal.
• Relative bradycardia, splenomegaly, abdominal tenderness and distention, with rose spots.
• Leucopenia, positive blood culture in first week and positive stool and urine culture.
• Positive widal test with increasing titre.
Drug of choice
-Ciprofloxacin 500 mg bd × 10 days or Tefloxacin 400 mg bd or Norflox 400 mg bd or Ofloxacin 200 mg bd or Cefuraxime 500 mg bd × 7 days.
-Hydrocortisone 100 mg IV 8 hourly in severely toxic patients, the danger of perforation should be weighed carefully.
-Parenteral fluid and vitamins control fever.
-High calorie and low residue diet.
-Perforation needs immediate surgery.