Current concepts in the diagnosis and treatment of typhoid fever

Although advances in public health and hygiene have led to the virtual disappearance of enteric fever (more commonly termed typhoid fever) from much of the developed world, the disease remains endemic in many developing countries. Typhoid fever is caused by Salmonella enterica serovar Typhi (S typhi), a Gram negative bacterium. A similar but often less severe disease is caused by S paratyphi A and, less commonly, by S paratyphi B (Schotmulleri) and S paratyphi C (Hirschfeldii). The common mode of infection is by ingestion of an infecting dose of the organism, usually through contaminated water or food. Although the source of infection may vary, person to person transmission through poor hygiene and sewage contamination of water supply are the most important.