Paratyphoid A01.4

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Notifiable salmonella infection with typhoid-like course.

Pathogen
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Salmonella paratyphi.

Occurrence/Epidemiology
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Incidence (Germany): 0.1-0.2/100,000 inhabitants/year. The diseases occur predominantly in migrants (India, Turkey, Pakistan, Nepal, Asian republics of the former Soviet Union).

Clinical features
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  • Extracutaneous manifestations: The incubation period is 1-10 days depending on the severity of the infection. Gastrointestinal symptoms with diarrhoea, nausea, vomiting, abdominal pain and fever up to 40 °C may be present with varying degrees of severity. Mostly there is a slight jaundice.
  • Integument: After 10-14 days an exanthema develops which is at first truncated with numerous monomorphic red spots (roseoles). In the course of the disease the exanthema spreads to the extremities, hands and feet are free. There are often associations with recurrent herpes simplex labialis.

Therapy
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The antibiotic systemic therapy with gyrase inhibitors such as ciprofloxacin 2 times/day 500 mg p.o. or a broad-spectrum cephalosporin (e.g. ceftriaxone) is in the foreground. Therapy duration: 2 weeks. Alternatively: trimethoprim-sulfamethoxazole or β-lactam antibiotics like ampicillin. For the sanitation of permanent eliminators, the administration of ciprofloxacin over a period of 4 weeks or of ceftriaxone for 2 weeks is recommended.

Progression/forecast
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In early stages of the disease, usually complete healing under antibiotic systemic therapy. About 1-5% of patients develop into permanent eliminators. A survived typhus disease leaves behind an immunity that lasts for about one year, but which can be broken at any time with a high dose of infection.

Prophylaxis
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Vaccination before travelling to endemic areas.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020