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Symptoms
By Mayo Clinic staffAlthough children with typhoid fever sometimes become sick suddenly, signs and symptoms are more likely to develop gradually — often appearing one to three weeks after exposure to the disease.
First week of illness
Once signs and symptoms do appear, you're likely to experience:
- Fever, often as high as 103 or 104 F (39.4 or 40 C)
- Headache
- Weakness and fatigue
- Sore throat
- Abdominal pain
- Diarrhea or constipation
- Rash
Children are more likely to have diarrhea, whereas adults may become severely constipated. During the second week, you may develop a rash of small, flat, rose-colored spots on your lower chest or upper abdomen. The rash is temporary, usually disappearing in two to five days.
Second week of illness
If you don't receive treatment for typhoid fever, you may enter a second stage during which you become very ill and experience:
- Continuing high fever
- Either diarrhea that has the color and consistency of pea soup, or severe constipation
- Considerable weight loss
- Extremely distended abdomen
Third week of illness
By the third week, you may:
- Become delirious
- Lie motionless and exhausted with your eyes half-closed in what's known as the typhoid state
Life-threatening complications often develop at this time.
Fourth week of illness
Improvement may come slowly during the fourth week. Your fever is likely to decrease gradually until your temperature returns to normal in another week to 10 days. But signs and symptoms can return up to two weeks after your fever has subsided.
When to see a doctor
See a doctor immediately if you suspect you have typhoid fever. If you become ill while traveling in a foreign country, call the U.S. Consulate for a list of doctors. Better yet, find out in advance about medical care in the areas you'll visit, and carry a list of the names, addresses and phone numbers of recommended doctors.
If you develop signs and symptoms after you return home, consider consulting a doctor who focuses on international travel medicine or infectious diseases. A specialist may be able to recognize and treat your illness more quickly than can a doctor who isn't trained in these areas.
- Hohmann EL. Epidemiology, microbiology, clinical manifestations, and diagnosis of typhoid fever. http://www.uptodate.com/home/index.html. Accessed March 8, 2010.
- Hohmann EL. Pathogenesis of typhoid fever. http://www.uptodate.com/home/index.html. Accessed March 8, 2010.
- Mintz E. The pre-travel consultation: Travel-related vaccine-preventable diseases: Typhoid and paratyphoid fever. In: Brunette GW, et al. CDC Health Information for International Travel 2010. Atlanta, Ga.: U.S. Department of Health and Human Services, Public Health Service; 2009. http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/typhoid-paratyphoid-fever.aspx. Accessed March 9, 2010.
- Typhoid fever. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm. Accessed March 9, 2010.
- Levine MM. Typhoid fever. In: Brachman PS, et al. Bacterial infections of humans: Epidemiology and control. 4th ed. New York, N.Y.: Springer; 2009:913.
- Bhutta ZA. Current concepts in the diagnosis and treatment of typhoid fever. British Medical Journal. 2006;333:78.
- Kaye KS, et al. Salmonella infections (including typhoid fever). In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/187350346-3/0/1492/1157.html?tocnode=54626101&fromURL=1157.html#4-u1.0-B978-1-4160-2805-5..50334-7_14301. Accessed March 9, 2010.
- Hohmann EL. Treatment and prevention of typhoid fever. http://www.uptodate.com/home/index.html. Accessed March 8, 2010.
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