Natural Course of Disease of Typhoid Fever

Incubation
Period (714 days)

First Week

Secondary Bacteremia
Symptoms (not specific) :

High Grade Fever

Abdominal
Pain/Discomfort

Diarrhea/Constipation

Vomitting

Anorexia

Hepato and/or Splenomegaly

Jaundice

Ingestion,
Primary
Bacteremia
Asymptomatic

Etc

Progression of Symptoms
(not specific) :

Fever usually plateaus at

40oC
Soft splenomegaly is
common
Relative bradycardia,
dicrotic pulse may develop
Delirium, rose spots,
ronchi may develop.
Lab :

Lab :

Second Week

CDC
Blood Culture
Fecal Culture
(optional)
Bone Marrow
Culture (not
routinely done)
Serologic Test
(Widal Test
usually is still
negative)

Third Week

Progression of Symptoms,
Complications May Develop,
eg :

Intestinal Hemorrhage
Intestinal Perforation
Encephalitis, Meningitis
Metastatic Abcesses
Guillain-Barr Syndrome
Ataxia, Seizure
Etc

Fourth Week

Convalesence
Lab :

Widal Test
(four-fold
increase of
Widal Test
result confirms
the diagnosis of
Typhoid Fever)

Widal Test
(10th-12th days)
Relapse
Reinfection