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paratyphoid fever
Classification:
- A, B & C
Etiology:
- Salmonella paratyphi
Epidemiology:
- transmitted by contaminated food or water
- humans, occasionally, domestic animals are carriers
- Salmonella paratyphi is commonly shed in the stool for 1-2 weeks after recover, but shedding may persist for up to one year
- chronic carriers with Schistosomiasis may shed Salmonella paratyphi in the urine
Clinical manifestations:
- sustained fever
- headache
- abdominal pain
- malaise
- anorexia
- non productive cough (early)
- relative bradycardia
- hepatosplenomegaly
- rosy spots on the central body (30% of Caucasians)
- in adults, constipation is more common than diarrhea
- psychosis, confusion, seizures (rare)
Laboratory:
- stool culture feces for Salmonella
- urine culture only for suspected chronic carrier
- antibiotic sensitivity
Differential diagnosis:
- typhoid fever
- resembles typhoid fever, but with
- more abrupt onset
- milder symptoms
- shorter course
Management:
- emperic therapy with guidance from antibiotic sensitivity
- fluoroquinolone for 10 days
- ciprofloxacin
- levofloxacin
- ampicillin
- trimethoprim-sulfamethoxazole
- ceftriaone or cefotaxime for 14 days
- aziththromycin for 5 days
Notes:
- reportable disease:
- California code of regulations section 2500
Related
Salmonella paratyphi
typhoid (enteric) fever
General
bacterial infection
References
- Wikipedia: Paratyphoid fever
http://en.wikipedia.org/wiki/Paratyphoid_fever
- Paratyphoid fever
Department of Public Health
http://www.publichealth.lacounty.gov/acd/procs/b73/DiseaseChapters/B73ParatyphoidFever.pdf