Typhoid Fever Symptoms and Complications: What To Watch Out For

Typhoid fever is an acute yet potentially fatal food-borne illness. Following this, it is important to watch out for typhoid fever symptoms and begin treatment early.

Typhoid fever affects the intestinal tract and can spread throughout other parts of the body. This infection is due to Salmonella typhi, a type of bacteria.

People may acquire typhoid fever from consuming contaminated food and drinks, including water. Typhoid fever is most common in countries with poor sanitation and limited access to clean water. Salmonella typhi can be found in human stool and urine. Transmission can occur when a carrier or infected person handles food with unwashed hands containing Salmonella typhi bacteria.

Typhoid Fever Cases

The World Health Organization (WHO) estimates about 11 to 21 million cases of typhoid fever yearly, with reported deaths ranging from 128,000 to 161,000. In 2019, the Philippines recorded 16,888 infections and 30 deaths from the disease.

Typhoid fever is curable with antibiotics. Some vaccines can be taken to minimize the chances of acquiring the bacteria associated with the disease. It is also preventable by practicing good hygiene and food preparation. However, it is still important to be aware of typhoid fever symptoms to avoid further progression and worsening of the disease.

Typhoid Fever Symptoms

Typhoid fever symptoms may manifest in a person 1-2 weeks after being infected with the Salmonella strain that causes the disease. The main symptoms of this illness include the following:

Continuous high fever

Patients can experience fever that may reach as high as 40°C. Typhoid fever typically follows a “stepwise pattern”, which means the body’s temperature gradually rises after waking up in the morning and goes back down after resting at night. However, not all cases of typhoid fever will experience this pattern.

Headache and Body Pains

Along with high fever, patients may also experience a headache. They can also experience body and muscle pain.

Dry Cough

Typhoid fever can also come with coughing but without phlegm or mucus.

Stomach Pain

As the bacteria that cause typhoid fever attacks the intestinal tract, patients may experience stomach ache. They may also experience either of the following:

• Constipation – This is when bowel movements occur less frequently and stools becomes harder to pass.
• Diarrhea – The opposite of constipation, patients may experience more frequent and watery stool.

Loss of Appetite

Patients may also experience a loss of appetite alongside stomach pain and digestive complications.

Rashes

These may appear as small red rose-colored spots on the abdomen or chest. 

Typhoid Fever Complications

People who haven’t been treated with medication early on may experience the following complications:

Internal Bleeding

Gastrointestinal bleeding is the most common complication associated with typhoid fever, occuring in up to 10% of all patients. While most cases are not life-threatening, severe bleeding may require a blood transfusion or surgery. The symptoms associated with this complication are the following:

• Blood in vomit (may have a “coffee ground” appearance)
• Dark, tar-like feces
• Extreme fatigue
• Breathlessness
• Paleness of Skin
• Arrhythmia (irregular heartbeat)

Intestinal Perforation and Peritonitis

This refers to an inflammation of the peritoneum or the lining of the abdomen which covers the stomach, kidney, liver, and intestines. Perforation is considered the second most common and severe complication. The Salmonella typhi bacteria can invade lymphoid tissue in the intestines, causing tissue destruction and formation of holes or perforations.

Because the intestine is home to millions of gut bacteria, both “good” and “bad”, any perforation can cause spillage of these bacteria into the abdominal space and eventually infect the peritoneum. Both intestinal perforation and peritonitis are medical emergencies, as these conditions can lead to sepsis, multi-organ damage, and even death.

These complications may be alarming. However, these can be avoidable through, early recognition and treatment of typhoid fever.

Key Takeaway

Typhoid fever can be acquired through consumption of food and water contaminated with the bacteria Salmonella typhi. This disease can be treated by taking prescribed antibiotics. Prevention can be done through proper hygiene measures and food handling and preparation. Thus, early detection and treating typhoid fever is the key to preventing serious complications.