Typhoid infection is a fecal-oral transmissible disease caused by the bacteria Salmonella enterica, serotype S typhi and Salmonella enterica, serotype S paratyphi.
It is seen in developed countries mainly among travelers returning from endemic countries.
Highest incidence is in the Indian subcontinent and, parallel to that, among travelers returning from that area.
Typhoid vaccine does not protect from paratyphoid infection.
Prolonged febrile illness with normal WBC count in returnees from an endemic area should increase suspicion.
Definitive diagnosis is by blood culture.
Presumptive antibiotic treatment in the traveler should depend upon the country of origin.
Rose spots on abdomen of a patient with typhoid fever
CDC/Armed Forces Institute of Pathology, Charles N. Farmer