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    related to: what to do if you have paratyphoid fever in children with pneumonia
  2. Pneumonia is an infection of the lungs and respiratory system that typically starts with. a slight cough. As symptoms persist a person may develop a high fever and have

  1. Symptoms of typhoid fever and paratyphoid fever include stomach pains, headache, or loss of appetite. If you have been treated take all of your prescribed antibiotics, wash your hands, and have doctor perform stool cultures.

    • Infectious Agent
    • Transmission
    • Epidemiology
    • Clinical Presentation
    • Diagnosis
    • Treatment
    • Prevention

    Salmonella entericaserotypes Typhi and Paratyphi A, Paratyphi B, and Paratyphi C cause potentially severe and occasionally life-threatening bacteremic illnesses referred to respectively as typhoid and paratyphoid fever, and collectively as enteric fever. Paratyphi B is differentiated into 2 distinct pathotypes on the basis of their ability to ferment tartrate—one is unable to ferment tartrate and is associated with paratyphoid fever (referred to as Paratyphi B), and the other ferments tartrate and is associated with uncomplicated gastroenteritis (referred to as Paratyphi B var. L(+) tartrate+).

    Humans are the only source of these bacteria; no animal or environmental reservoirs have been identified. Typhoid and paratyphoid fever are acquired through consumption of water or food contaminated by feces of an acutely infected or convalescent person or a chronic, asymptomatic carrier. Risk for infection is high in low- and middle-income countries with endemic disease and poor access to safe food, water, and sanitation. Transmission through sexual contact, especially among men who have sex with men, has been documented rarely.

    An estimated 26 million cases of typhoid fever and 5 million cases of paratyphoid fever occur worldwide each year, causing 215,000 deaths. In the United States during 2008–2015, approximately 350 culture-confirmed cases of typhoid fever and 90 cases of paratyphoid fever caused by Paratyphi A were reported each year. Cases of paratyphoid fever caused by Paratyphi B and Paratyphi C are rarely reported. Approximately 85% of typhoid fever and 92% of paratyphoid fever cases in the United States occur among international travelers; of those, 80% of typhoid and 91% of paratyphoid fever cases caused by Paratyphi A are acquired by travelers to southern Asia (primarily India, Pakistan, or Bangladesh). Other high-risk regions for typhoid and paratyphoid fever include Africa and Southeast Asia; lower-risk regions include East Asia, South America, and the Caribbean. Travelers visiting friends and relatives are at increased risk, as they may be less careful with food and water while abroad and ma...

    The incubation period of typhoid and paratyphoid infections is 6–30 days. The onset of illness is insidious, with gradually increasing fatigue and a fever that increases daily from low-grade to as high as 102°F–104°F (38°C–40°C) by the third to fourth day of illness. Fever is commonly lowest in the morning, peaking in the late afternoon or evening. Headache, malaise, and anorexia are nearly universal, and abdominal pain, diarrhea, or constipation are common. Vomiting and diarrhea are more common in children compared with adults. People can also have fatigue, myalgias, dry cough, and sore throat. Hepatosplenomegaly can often be detected. A transient, maculopapular rash of rose-colored spots can occasionally be seen on the trunk. The clinical presentation is often confused with malaria, and typhoid fever should be suspected in a person with a history of travel to an endemic area who is not responding to antimalarial medication. Untreated, the disease can last for a month, and reported...

    Patients with typhoid or paratyphoid fever have bacteremia. Blood culture is the mainstay of diagnosis in typhoid and paratyphoid fever; however, a single culture is positive in only approximately 50% of cases. Multiple cultures increase the sensitivity and may be required to make the diagnosis. Bone marrow culture increases the diagnostic yield to approximately 80% of cases and is relatively unaffected by previous or concurrent antibiotic use. Stool culture is not usually positive during the first week of illness, so blood culture is preferred. Urine culture has a lower diagnostic yield than stool culture for acute cases. The Widal test is unreliable but is widely used in developing countries because of its low cost. It measures elevated antibody titers in patients with recent typhoid or paratyphoid fever but may not accurately distinguish acute from past infection and lacks specificity, resulting in false-positive results. Serologic assays are not an adequate substitute for blood,...

    Antibiotic therapy shortens the clinical course of enteric fever and reduces the risk for death. Fluoroquinolones (such as ciprofloxacin) are often used for empiric treatment of enteric fever in adults and are considered the treatment of choice for fluoroquinolone-susceptible infections. However, most infections in the United States are acquired during travel abroad, particularly to regions where enteric fever is endemic and fluoroquinolone nonsusceptibility among Typhi and Paratyphi A isolates is common. Fluoroquinolone-nonsusceptible infections are also usually resistant to the synthetic quinolone, nalidixic acid, and have been associated with treatment failure or delayed clinical response. In the United States, ≥90% of Typhi and Paratyphi A infections in travelers to South Asia were found to be fluoroquinolone-nonsusceptible or nalidixic acid–resistant, which suggests that treatment failures may occur among patients treated empirically with fluoroquinolones. Increasingly, azithro...

    Food and Water

    Safe food and water precautions and frequent handwashing (especially before meals) are important in preventing typhoid and paratyphoid fever (seeChapter 2, Food & Water Precautions). Although vaccines are recommended to prevent typhoid fever, they are not 100% effective, and vaccine-induced immunity can be overwhelmed by a large bacterial inoculum; therefore, even vaccinated travelers should follow recommended food and water precautions. For paratyphoid fever, food and water precautions are t...

    Vaccine

    The Advisory Committee on Immunization Practices (ACIP) recommends typhoid vaccine for travelers to areas where there is a recognized risk for exposure to Typhi. Destination-specific vaccine recommendations are available at the CDC Travelers’ Health website (www.cdc.gov/travel). Two unconjugated typhoid vaccines are licensed and available in the United States: 1. Vi capsular polysaccharide vaccine (ViCPS) (Typhim Vi, manufactured by Sanofi Pasteur) for intramuscular use 2. Oral live attenuate...

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  3. The most common symptoms of paratyphoid infection include high fever, headaches, weakness, loss of appetite, and diarrhea or constipation. Some people get “rose-colored spots” on the front of the chest during the first week of illness. Symptoms of paratyphoid infection are similar to typhoid infection, but are typically milder.

  4. Dec 13, 2010 · To the Editor: Enteric fever is a major public health problem in India, accounting for more than 300,000 cases per year, Salmonella typhi is the most common etiologic agent , but Salmonella paratyphi A, the other causative agent, causes more asymptomatic infections than S. typhi.

  5. Typhoid fever and paratyphoid fever are most common in parts of the world where water and food may be unsafe and sanitation is poor. Travelers to South Asia, especially Pakistan, India, and Bangladesh, should take precautions to prevent infection. Typhoid fever and paratyphoid fever are somewhat less common in East Asia, Africa, the Caribbean ...

  6. Typhoid and paratyphoid fevers are bacterial infections of the intestinal tract and bloodstream. Almost every Australian case is acquired during overseas travel, with about 50 to 60 Victorians treated each year. Symptoms and signs include diarrhoea, fever, tiredness, enlarged spleen and liver, and characteristic skin rash.

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