How often do patients treated for typhoid fever (enteric fever) become chronic carriers of Salmonella typhi (S typhi) or S paratyphi?

Updated: Aug 19, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Depending on the antibiotic used, between 0% and 5.9% of treated patients become chronic carriers. In some cases, the organism evades antibiotics by sequestering itself within gallstones or Schistosoma haematobium organisms that are infecting the bladder. From there, it is shed in stool or urine, respectively. If present, these diseases must be cured before the bacterium can be eliminated.

Untreated survivors of typhoid fever may shed the bacterium in the feces for up to 3 months. Therefore, after disease resolution, 3 stool cultures in one-month intervals should be performed to rule out a carrier state. Concurrent urinary cultures should be considered.


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