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.