Typhoid and paratyphoid fever

For a lay person:

Typhoid and paratyphoid fever are bacterial infections spread through food and water contaminated with faeces, mainly where sanitation is poor. They cause a high, prolonged fever and abdominal symptoms, and without treatment can lead to serious complications such as bowel bleeding or perforation.

For a trained medical person:

Enteric fever is caused by Salmonella enterica serovars Typhi and Paratyphi A, B or C, with bacteraemia and Peyer's patch involvement; complications include intestinal haemorrhage and perforation, encephalopathy and chronic carriage. Diagnosis is by blood culture, with bone marrow culture more sensitive, as serological tests are unreliable. Treatment is antibiotics chosen by local resistance patterns, such as azithromycin or ceftriaxone, with vaccination and sanitation for prevention.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Beginning Stage; Peak Stage; Excess Blood Heat; Deficient Collapse. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Get urgent medical care for a persistent fever after travel or possible exposure, and emergency care for severe abdominal pain or bleeding from the bowel; typhoid is notifiable to public health and needs antibiotics, with Chinese medicine adjunctive at most.