The most serious complication of typhoid fever is intestinal bleeding or perforation, which may develop in the third week of illness. About 5% of individuals with typhoid fever experience this complication. Intestinal bleeding is often marked by a sudden drop in blood pressure and shock, followed by the appearance of blood in the stool. A perforated intestine occurs when the small intestine or large bowel develops a hole, causing intestinal contents to leak into the abdominal cavity. This triggers signs and symptoms such as severe abdominal pain, nausea, vomiting, and blood stream infection (sepsis). This life-threatening emergency requires immediate medical care. Intestinal perforation causes nearly a quarter of the deaths that occur from typhoid fever.
Other, less common complications of typhoid fever include: myocarditis or inflammation of the heart muscle (symptoms may include shortness of breath, chest pain, and irregular heart beats); pneumonia (symptoms include shortness of breath, cough, and lung pain); pancreatitis or inflammation of the pancreas (symptoms include nausea, fever, and pain); kidney or bladder infections (symptoms include painful urination and fever); osteomyelitis or infections of the bone (symptoms include pain); meningitis or infection and inflammation of the membranes and fluid surrounding the brain and spinal cord (symptoms include fever, chills, and fatigue); and psychiatric problems such as delirium, hallucinations, and paranoid psychosis.
With prompt treatment, nearly all individuals in industrialized nations recover from typhoid, but without treatment, some individuals may not survive the above complications of the disease.
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