Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in industrialized countries. However, it remains a serious health threat in the developing world, especially for children.

Typhoid fever spreads through contaminated food and water or through close contact with someone who's infected. Signs and symptoms usually include high fever, headache, abdominal pain, and either constipation or diarrhea.

When treated with antibiotics, most people with typhoid fever feel better within a few days, although a small percentage of them may die of complications.

Vaccines against typhoid fever are available, but they're only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or are traveling to areas where typhoid fever is common.

SYMPTOMS
Although 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.

1st week of illness
Once signs and symptoms do appear, you're likely to experience:

Fever, that starts low and increases daily, often to as high as 103 or 104 F (39.4 or 40 C)
Headache
Weakness and fatigue
Dry cough
Loss of appetite
Abdominal pain
Diarrhea or constipation
Rash
2nd 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 or severe constipation
Considerable weight loss
Extremely distended abdomen
3rd 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.
COMPLICATIONS
Intestinal bleeding or holes
The most serious complication of typhoid fever — intestinal bleeding or holes (perforations) — may develop in the third week of illness. About 5 percent of people with typhoid fever experience this complication.

Intestinal bleeding is often marked by a sudden drop in blood pressure and shock, followed by the appearance of blood in your stool.

A perforated intestine occurs when your small intestine or large bowel develops a hole, causing intestinal contents to leak into your abdominal cavity and triggering signs and symptoms such as severe abdominal pain, nausea, vomiting and bloodstream infection (sepsis). This life-threatening emergency requires immediate medical care.
TREATMENTS AND DRUGS
Antibiotic therapy is the only effective treatment for typhoid fever.

Commonly prescribed antibiotics
Ciprofloxacin (Cipro). In the United States, doctors often prescribe this for nonpregnant adults.
Ceftriaxone (Rocephin). This injectable antibiotic is an alternative for women who are pregnant and for children who may not be candidates for ciprofloxacin.
These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria.

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