Enteric fever


Buddha Basnyat, Farah Naz Qamar, Priscilla Rupali, Tahmeed Ahmed, Christopher M Parry


What you need to know

  • In endemic areas and in returning travellers, consider enteric fever in the differential diagnosis in patients with acute fever, particularly if they have abdominal symptoms

  • Routine blood tests and blood culture can aid the diagnosis; serological tests, including the Widal test, are not recommended

  • Antimicrobial resistance is common, so refer to national guidelines or formularies for choice of antibiotic

  • In endemic areas, rule out other causes of acute fever such as malaria and dengue with tests and consider adding empirical treatment with doxycycline (or azithromycin) for scrub typhus and leptospirosis

  • The Vi polysaccharide vaccine and Ty21a vaccine are available for use in travellers. The typhoid Vi conjugate vaccine is now recommended by the WHO in endemic areas

Click here to read the article, published in The BMJ.