What are symptoms of typhoid

Symptoms

The incubation period at Typhus abdominalis is usually 1-2 weeks, but can vary considerably (between 3 and 60 days); in paratyphoid it is 1–10 days. The first signs of the disease are not very characteristic (so-called prodromal stage, i.e. the phase of the disease in which uncharacteristic signs or early symptoms, the so-called prodromes, occur) with headache and body aches, possibly also with slightly increased body temperature. Then within 2–3 days there is a slow (step-shaped) increase in fever and a clear general feeling of illness with drowsiness and uncharacteristic abdominal discomfort (Stage incrementi). The body temperature can reach high values ​​around 40 ° C and mostly fluctuates little (so-called. Continua). Fever-lowering measures often have only a limited effect. The tongue is gray-yellow with free reddish borders (so-called typhus tongue).

In the 2nd week of illness (Stage acmes) In some of the patients, small, bright red, pinhead-sized (2–4 mm), non-itchy rashes (roseoles), mostly on the skin of the abdomen, appear. A slow pulse in relation to the high fever (relative bradycardia) is often noticeable. Often there is initially constipation, only later - in the 2nd or 3rd week of the disease - do the typical pea-like diarrhea appear. These are based on an inflammation of the lymph vessels in the mucous membrane of the small intestine caused by the bacteria (so-called Peyer's plaques). In patients who are not treated with antibiotics, the high temperatures around 40 ° C can last up to 3 weeks or fluctuate daily (Amphibolic stage) and this is often followed by a long period of convalescence (Stage decrementi). If the elevated (subfebrile) temperatures are still detectable, a recurrence of the disease (relapse or relapse) is to be expected. Multiple relapses are also possible.

The clinical course of paratyphoid fever is similar to that of typhoid fever, but it is usually less pronounced. Gastroenteritic forms with diarrhea, nausea, vomiting, abdominal pain and fever of up to 39 ° C occur more frequently. The duration of the illness is 4–10 days.

A typhoid fever that has been overcome leaves an immunity that lasts for about a year, which can be broken at any time with a high infectious dose.

Effects & Complications

Complications usually only occur after the first week of illness and can then quickly become life-threatening. The most common intestinal bleeding and perforation of the intestine with peritonitis occurs in untreated patients. Further complications are inflammation of the pancreas, gall bladder, bones, heart valves and meninges as well as thromboses in the pelvic and leg veins with the risk of embolism of the lungs and other organs.

In children under one year of age, the disease is more severe and more likely to have complications. Without antibiotic treatment, 2 to 5% of patients can become permanent excretors; this can rarely also occur after antibiotic treatment. The usually symptom-free permanent eliminators (permanent carriers) of Salmonella Typhi or Salmonella Paratyphi the bacteria excrete with the stool (rarely urine) for longer than 6 months, sometimes even for life. They can thus be a source of infection for the environment (sewage contamination) and other people. Permanent eliminators known in Germany are mostly older than 50 years and more often women. The permanent excretion of S. Typhi can be caused by chronic colonization of either the intestine or the gallbladder.