Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- febre alta
Other diagnostic factors
- incômoda cefaleia frontal
- dor abdominal
- anorexia
- estado apático-letárgico
- constipação
- tosse
- diarreia
- mal-estar
- náuseas
- prostração
- calafrios
- hepatomegalia
- pneumonia
- bradicardia relativa
- calafrios
- manchas rosadas
- esplenomegalia
Risk factors
- adensamento populacional em áreas endêmicas
- saneamento básico deficiente/água não tratada em áreas endêmicas
- higiene pessoal precária em áreas endêmicas
- visita a países endêmicos (por exemplo, subcontinente indiano, México)
- viagem para áreas com saneamento básico deficiente dentro de países endêmicos
- desrespeito às regras de higiene durante viagem em países endêmicos
- viagem para o subcontinente indiano
- duração maior da visita em país endêmico
- tratamento com antiácido/inibidor da bomba de prótons (IBP)
Diagnostic investigations
1st investigations to order
- Hemograma completo
- transaminases séricas
- hemocultura
- coprocultura
- urocultura
- cultura de medula óssea
- teste de sensibilidade a medicamentos
Investigations to consider
- cultura de manchas rosadas
Treatment algorithm
suspeita de febre entérica
febre entérica confirmada
recidiva
portador crônico
Contributors
Authors
Eli Schwartz, MD, DTMH
Professor
Center for Geographical Medicine and Tropical Diseases
Chaim Sheba Medical Center
Tel HaShomer Hospital
Clinical Professor of Medicine
Sackler Faculty of Medicine
Tel Aviv University
Tel Aviv
Israel
Disclosures
ES is an author of a number of references cited in this topic.
Bradley A. Connor, MD
Clinical Associate Professor
Weill Medical College of Cornell University
New York Center for Travel and Tropical Medicine
New York City
NY
Disclosures
BAC declares that he has no competing interests.
Peer reviewers
Chris Parry, MD
Senior Lecturer (Honorary Consultant)
Division of Medical Microbiology and Genitourinary Medicine
School of Infection and Host Defence
University of Liverpool
Liverpool
UK
Disclosures
CP declares that he has no competing interests.
Paul M. Southern, MD, MSc, DTM&H
Professor
Department of Pathology
University of Texas Southwestern Medical Center
Dallas
TX
Disclosures
PMS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
World Health Organization. Typhoid vaccines position paper. Mar 2018 [internet publication].Full text
Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ. 2004 May;82(5):346-53.Full text Abstract
Schwartz E, Shlim DR, Eaton M, et al. The effect of oral and parenteral typhoid vaccination on the rate of infection with Salmonella typhi and Salmonella paratyphi A among foreigners in Nepal. Arch Intern Med. 1990 Feb;150(2):349-51. Abstract
Ochiai RL, Wang X, von Seidlein L, et al. Salmonella paratyphi A rates, Asia. Emerg Infect Dis. 2005 Nov;11(11):1764-6.Full text Abstract
Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - typhoid & paratyphoid fever. May 2023 [internet publication].Full text
Engels EA, Falagas ME, Lau J, et al. Typhoid fever vaccines: a meta-analysis of studies on efficacy and toxicity. BMJ. 1998 Jan 10;316(7125):110-6.Full text Abstract
Jackson BR, Iqbal S, Mahon B; Centers for Disease Control and Prevention (CDC). Updated recommendations for the use of typhoid vaccine - Advisory Committee on Immunization Practices, United States, 2015. MMWR Morb Mortal Wkly Rep. 2015 Mar 27;64(11):305-8.Full text Abstract
Frenck RW Jr, Nakhla I, Sultan Y, et al. Azithromycin versus ceftriaxone for the treatment of uncomplicated typhoid fever in children. Clin Infect Dis. 2000 Nov;31(5):1134-8.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Malária
- Dengue
- Infecções por rickettsias
More DifferentialsGuidelines
- Public health operational guidelines for typhoid and paratyphoid (enteric fever)
- Yellow Book 2024: health information for international travel: typhoid and paratyphoid fever
More Guidelines
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