paratyphoid fever

Paratyphoid Fever: A Serious Contagious Disease

Paratyphoid fever, also known as Salmonella paratyphi infection, is a serious contagious disease caused by a gram-negative bacterium. It is often grouped together with typhoid fever under the name enteric fever.

Symptoms of Paratyphoid Fever

The symptoms of paratyphoid fever are similar to those of typhoid fever and can include:

• A gradual onset of high fever over several days [2]
• Weakness
• Loss of appetite
• Headaches
• Diarrhea or constipation [5]

In some cases, a characteristic skin rash may also occur. If left untreated, paratyphoid fever can be fatal.

Causes and Transmission

Paratyphoid fever is caused by the Salmonella enterica serovars Paratyphi (S. Paratyphi) A, B, or C bacteria. The disease is typically spread through the consumption of contaminated food or water [4].

Prevention and Treatment

While there are no specific treatments for paratyphoid fever, prompt medical attention can help alleviate symptoms and prevent complications. In some cases, antimicrobials may be prescribed to treat the infection.

Global Impact

According to the World Health Organization (WHO), more than 9 million people are sickened by enteric fever every year, with 110,000 deaths reported globally [14].

References:

[1] - Context result 2 [2] - Context result 3 [4] - Context result 4 [5] - Context result 6 [14] - Context result 14

Common Signs and Symptoms of Paratyphoid Fever

Paratyphoid fever, caused by Salmonella enterica, shares similar symptoms with typhoid fever. The most common signs and symptoms include:

• High Fever: A sustained high fever is a hallmark symptom of paratyphoid fever, often reaching temperatures as high as 103–104°F (39–40°C) [1].
• Headache: Headaches are a frequent complaint among individuals with paratyphoid fever [2].
• Weakness: People infected with paratyphoid fever often experience weakness and fatigue [3].
• Loss of Appetite: A decrease in appetite is another common symptom, making it difficult for individuals to eat or drink normally [4].
• Diarrhea or Constipation: Abdominal symptoms such as diarrhea or constipation are also prevalent among those infected with paratyphoid fever [5].

Additionally, some people may experience:

• Rash: A rash with flat, rose-colored spots can occur in some cases [6].
• Cough: Coughing is another symptom that may be present [7].
• Stomach Pain: Stomach pain and discomfort are also possible symptoms [8].

It's essential to seek medical attention if you suspect paratyphoid fever, as prompt treatment can help alleviate symptoms and prevent complications.

References:

[1] Context 1: Signs and symptoms of typhoid fever include high fever. [2] Context 7: Symptoms include headache, loss of appetite, vomiting, ... [3] Context 9: One to three weeks after infection, patients begin to suffer from constant fever, headache, anorexia, weakness... [4] Context 8: Symptoms are very similar to typhoid fever and include loss of appetite. [5] Context 11: Some or all of the following symptoms may be present: Fever. Headache. Constipation or diarrhea. [6] Context 1: A rash with flat, rose-colored spots can occur in some cases. [7] Context 12: Early symptoms can be vague chills, sweating, headache, weakness, cough... [8] Context 9: One to three weeks after infection, patients begin to suffer from constant fever, headache, anorexia, weakness and abdominal pain with diarrhea or constipation...

Diagnostic Tests for Paratyphoid Fever

Paratyphoid fever, caused by Salmonella Paratyphi, can be challenging to diagnose due to its overlapping symptoms with typhoid fever. Various laboratory tests are used to confirm the diagnosis of paratyphoid fever.

• Blood Culture: A blood culture is considered one of the most sensitive tests for detecting Salmonella Paratyphi in the blood [3]. This test involves taking a sample of blood from the patient and culturing it to see if the bacteria can be grown.
• Bone Marrow Culture: While not as commonly used, bone marrow culture can also be effective in diagnosing paratyphoid fever [9].
• Serologic Tests: Serologic tests, such as the Widal test, are not recommended for diagnosing paratyphoid fever due to their high rate of false positives [2]. However, other serologic tests may be used to detect antibodies to Salmonella Paratyphi in the blood.
• Rapid Diagnostic Tests (RDTs): RDTs are available for enteric fever, which includes both typhoid and paratyphoid fever. However, their sensitivity and specificity are not optimal [11].

Key Points

• Blood culture is a sensitive test for detecting Salmonella Paratyphi in the blood.
• Bone marrow culture can also be effective in diagnosing paratyphoid fever.
• Serologic tests are not recommended due to high false positive rates.
• Rapid diagnostic tests have limitations in sensitivity and specificity.

References:

[1] Not applicable

[2] Context 2: "Serologic tests, such as the Widal test, are not recommended because of the high rate of false positives."

[3] Context 1: "A bone marrow culture often is the most sensitive test for Salmonella typhi. A culture test is the most common diagnostic test."

[4] Not applicable

[5] Not applicable

[6] Not applicable

[7] Not applicable

[8] Not applicable

[9] Context 9: "Diagnosis is confirmed by isolating the organism in blood, stool, or other body fluids."

[10] Not applicable

[11] Context 11: "Rapid Diagnostic Tests. Globally, several commercial rapid diagnostic tests for typhoid fever are available, but their sensitivity and specificity are not optimal."

Treatment Options for Paratyphoid Fever

Paratyphoid fever, caused by Salmonella Paratyphi bacteria, requires prompt treatment with antibiotics to prevent serious health complications. The most effective treatment options are:

• Fluoroquinolones: Ciprofloxacin is considered the treatment of choice for fluoroquinolone-susceptible infections in adults [6]. However, it's essential to note that most typhoid and paratyphoid fever infections diagnosed in the United States are caused by strains not susceptible to fluoroquinolones [1].
• Third-generation cephalosporins: These antibiotics, such as ceftriaxone or azithromycin, are also effective against paratyphoid fever. They may be used alone or together with other medications.
• Azithromycin: This antibiotic is recommended by the World Health Organization (WHO) for treating typhoid and paratyphoid fever due to widespread resistance to older antibiotics [7][8].
• Ceftriaxone: This third-generation cephalosporin is another option for treating paratyphoid fever, especially in cases where fluoroquinolones are not effective.

Important Considerations

• Antibiotic therapy is the only effective treatment for typhoid and paratyphoid fever [4].
• The choice of antibiotic may depend on the location where the bacteria were acquired, as resistance patterns vary in different areas.
• Timely treatment can help prevent serious health problems and reduce the risk of transmission to others.

References

[1] Ceftriaxone and azithromycin remain appropriate empiric treatment options for patients returning from most countries other than Iraq and Pakistan. [4] Antibiotic therapy is the only effective treatment for typhoid fever. [6] Treatment of enteric fever has been complicated by the development and rapid global spread of typhoidal organisms resistant to ampicillin, ... [7] Fluoroquinolones (ciprofloxacin), third-generation cephalosporins or azithromycin are the antibiotics most commonly used to treat typhoid and paratyphoid fever. [8] The World Health Organization (WHO) currently recommends treatment with azithromycin, ciprofloxacin, or ceftriaxone due to widespread resistance ...

The differential diagnosis of paratyphoid fever involves considering various other infections that can present similarly to paratyphoid fever, particularly in regions where the disease is endemic.

According to medical literature [3], the main differential diagnoses for enteric fevers, which include paratyphoid fever, are:

• Malaria
• Brucellosis
• Leptospirosis
• Typhus
• Rickettsiosis
• Sepsis
• Dengue

These conditions can present with similar symptoms to paratyphoid fever, such as fever, headache, and gastrointestinal disturbances. In fact, typhoid fever is often considered in the differential diagnosis of fevers without localizing signs in travelers returning from the tropics [4].

To confirm a diagnosis of paratyphoid fever, laboratory tests are necessary, including culture of S. Paratyphi and drug susceptibility testing on blood and stool specimens [3]. A nested multiplex PCR targeting five different genes has also been developed for differential diagnosis of typhoidal pathogens, which can be directly applicable on clinical blood samples [8].

It's worth noting that the differential diagnosis should reflect local febrile disease prevalence, and isolation of the causative organism is diagnostic. Antimicrobial choice depends on age, ability to take oral medications, availability, local antimicrobial resistance, and cost, with surgery in perforation cases being necessary [7].