Typhoid is a systemic infection caused by Salmonella organism. It is a multi-systemic disease. The most common presentation leading to surgical consultation is typhoid intestinal perforation(TIP). The TIP is also the most common cause of mortality. The serotypes commonly implicated in the causation of typhoid intestinal perforation are Salmonella Typhi and Salmonella Typhimurium and, to a lesser extent Paratyphi A, B and C
HISTORICAL PERSPECTIVE: It is believed that typhoid is named after Typhoid Mary, who was a cook. She was a chronic carrier who infected members of a royal family. Some other history believed that it was named after typhus before it was completely differentiated from typhoid as a separate disease entity.
Georges Widal described the blood agglutination reaction test, which now bear’s his name
EPIDEMIOLOGY
Transmission is feco-oral, by ingestion of foods or drinks contaminated with the organism. Examples of sources include water, food, poultry products, ice cream, salad and vegetables, sausage rolls, incompletely cooked foods, and meat
It is more common in the tropics and subtropics or developing countries
It is more common in males than females
It is more common in the rainy season when the surface waters run deep and contaminate the deeper water tables from where portable water is taken or sourced
Gastrointestinal bleeding occurs in about 10 percent of patients with typhoid fever, it is a more common complication than typhoid intestinal perforation, which occurs in 1-7% of patients with the disease. Generally, only 10-15 percent of patients with typhoid fever proceed to develop complications. Most others recover after treatment without any complication(s)
It is a disease of poor sanitation and poor sewage disposal system It is more common in patients between the ages of 5 and 35. The common indication for surgical consultation is ileal perforation