typhoid fever acute, generalized infection caused by Salmonella typhi. The main sources of infection are contaminated water or milk and, especially in urban communities, food handlers who are carriers. The symptoms of typhoid appear 10 to 14 days after infection; they include high fever, rose-colored spots on the abdomen and chest, diarrhea or constipation, and enlargement of the spleen. Complications, especially in untreated patients, may be numerous, affecting practically every body system, and they account for the mortality rate of 7% to 14%. Perforation of the intestine with hemorrhage is not uncommon.
Chloramphenicol was previously the preferred treatment for typhoid, but side effects associated with the drug and increased drug resistance have led to the use of the antibiotics ciprofloxacin and, for pregnant women and some children, ceftriaxone. Antibiotic resistance, however, is an increasing problem in treating typhoid fever, particularly in developing countries. Skilled nursing care is still of the utmost importance, as is drinking fluids to combat dehydration and fever and consuming a high caloric diet to prevent wasting of the body. Vaccination against typhoid is a valuable preventive measure, especially for persons in military service and for those who live in or travel to poorly sanitized regions.