What are intestinal complications of typhoid fever (enteric fever)?

Updated: Aug 19, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Intestinal manifestations may include the following:

  • The 2 most common complications of typhoid fever include intestinal hemorrhage (12% in one British series) and perforation (3%-4.6% of hospitalized patients).

  • From 1884-1909 (ie, preantibiotic era), the mortality rate in patients with intestinal perforation due to typhoid fever was 66%-90% but is now significantly lower. Approximately 75% of patients have guarding, rebound tenderness, and rigidity, particularly in the right lower quadrant.

  • Diagnosis is particularly difficult in the approximately 25% of patients with perforation and peritonitis who do not have the classic physical findings. In many cases, the discovery of free intra-abdominal fluid is the only sign of perforation.

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