Typhoid Fever

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A01.00 – Typhoid fever, unspecified

4834000 – Typhoid fever


Salmonella typhi, an aerobic gram-negative bacillus, is the etiologic agent of typhoid fever. Food or water contaminated directly or indirectly with human feces is the usual source of infection. After an incubation period of 8–14 days, there is an insidious onset of remittent fever that usually plateaus at 40°C (104°F). Chills, myalgias, lethargy, headache, epistaxis, dry cough, abdominal pain, constipation, and diarrhea can be seen. Findings include relative bradycardia, rhonchi, rales, abdominal distension, tenderness, splenomegaly, hepatomegaly, and guaiac-positive stools. The disease is more common in non-industrialized countries where sanitation is poor and hand washing is infrequent. In the United States, 75% of cases occur in patients aged younger than 30. Untreated, typhoid fever carries a 10% to 12% mortality rate. In 15% to 20% of treated patients, there is relapse after 2 weeks. Intestinal hemorrhage, bowel perforation, meningitis, chondritis, cholecystitis, pyelonephritis, orchitis, typhoid hepatitis, pneumonia, localized abscesses, endocarditis, and myocarditis are complications.

Although typhoid fever is rare in the US, 9 cases of typhoid fever were documented in CA and NV between April and July of 2010, with 7 of the patients requiring hospitalization. The CDC linked the majority of cases to the consumption of frozen mamey (also called "zapote" or "sapote"), a tropical fruit pulp product used in milkshakes and smoothies.

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