Enteric fever is a medical term encompassing two types of salmonellosis, which, specifically, are Salmonella enterica serovar Typhi (S Typhi), commonly known as Typhoid fever, and Salmonella enterica serovar Paratyphi A, B, or C (S Paratyphi), also known as paratyphoid fever. Both S Typhi and S Paratyphi are motile gram-negative bacteria in the Enterobacteriacae family. It is suggested that bacteria in the reticuloendothelial system reflects the bacterial disease burden. Cytokines which include IL-6 and TNF have been shown to be elevated in infection, however notably less than Gram-negative septic shock.There are two cycles of transmission that have been identified: short-cycle and long-cycle transmission. Short cycle-transmission is usually due to inadequate sanitation when bacteria contaminate the environment through acute or chronic carriers and Long cycle transmission is due to pollution of large bodies of water from sewage.
Presentations can vary among children and adults. Common clinical features in children include days of consecutive high fevers, nausea, vomiting, diarrhea or constipation, hepatomegaly, splenomegaly, and abdominal distention. Anemia and leukopenia are also common laboratory findings seen in this population. Younger children have also been documented to present with non-specific fever with inconclusive laboratory results and atypical clinical features.
thumb|Rose colored spots present on the chest of a patient with typhoid fever
In adults, clinical features of enteric fever include slowly rising fever over consecutive days, abdominal pain, nausea, vomiting, diarrhea or constipation, headache, anorexia, hepatosplenomegaly, and cough are also common. Most notably, rose spots, blanching erythematous maculopapular lesions usually about 2-4 mm in diameter are and usually present on the trunk, however rose spots are not pathognomonic for enteric fever.
The Global Burden of Disease Study estimates that there are about 9.3 million cases of enteric fever globally as of 2021 with the estimated global burden being estimated at around 62% in south Asia. As of 2021, the global mortality in 2021 was estimated at more than 100,000 deaths each year.
Treatment
Enteric Fever treatment consists of antibiotics and supportive care with monitoring for complications. Patients are treated empirically outpatient in the first week. After empiric treatment, if symptoms to do not resolve or worsen to vomiting, severe dehydration, hemodynamic instability the hospitalization is indicated.