Typhoid Fever and Its Nervous System Involvement

Abstract

Typhoid fever is a common cause of febrile illness. The causative organism S. Typhi uses special mechanisms to invade the intestines and then disseminates to the reticuloendothelial system. Thereafter, using the immune mechanism to its own advantage, it can reach the nervous system. The nervous system involvement usually occurs around the second week of fever. It usually occurs when the patient has severe sepsis. Neuropsychiatric manifestations are common, and fatigue is out of proportion to the fever. Diagnosis is often delayed, due to lack of diagnostic facilities in developing nations where it is common. In developed nations diagnosis is delayed as well, as often it is not suspected. Antibiotic therapy usually is effective, unless resistance is present, which is gradually becoming common. Early diagnosis and treatment usually leads to complete resolution of symptoms.