Rose Spots and Typhoid Fever

Typhoid fever is a bacterial infection in the digestive system, and in rarer cases, the blood stream. It is passed from the host to recipient through fecal matter that contains the infectious Salmonella typhi germ. The germ is most commonly ingested when water supplies, and occasionally food sources, are contaminated with feces or urine from an infected individual.

Rose Spots

• The symptom most commonly used to diagnose typhoid fever is the rash which accompanies the disease. This is because the rash, known as rose spots, is the only symptom specific to the typhoid bacteria. The New York Times Health Guide on Typhoid describes the rash as spots, generally less than a 1/4-inch across, and completely flat. They develop predominantly on the chest and abdominal region. Unfortunately, not all cases of typhoid will demonstrate this symptom.

Early Illness

• Victims begin experiencing symptoms anytime between one and three weeks after exposure to the bacteria occurs. In children, onset of severe symptoms may occur rapidly, but in older victims, the disease is likely to begin mildly and develop over time. The Mayo Clinic gives a specific time line for symptoms and complication development. This time line suggests that during the first week of illness, a fever, headache, sore throat and upset stomach may occur. These symptoms may be accompanied by a general sense of weakness. The upset stomach often becomes diarrhea in children, but is more likely to present as severe constipation in adults.

  During the second week of the disease rose spots often occur on the chest and belly. At this time, the patient also commonly experiences a continued high fever, weight loss and a distended abdomen. Constipation and diarrhea also typically continue. Diarrhea is said to look like pea soup, in both color and consistency.

Later Stages

• During the third week the rash disappears and the patient enters the typhoid state. The typhoid state is a term used to describe a motionless state with closed or half-closed eyes, when the patient seems to drift in and out of consciousness. During the typhoid state, life-threatening complications are most likely to occur. The turning point occurs during the fourth week of the disease. The fever drops gradually and returns to normal over the course of a week to 10 days. Victims should be observed for a period of at least two weeks for reoccurrence.

Diagnosis and Treatment

• When a rash is observed, or when multiple other symptoms are exhibited without a rash, a series of tests can be performed to gain a definitive diagnosis. According to the National Institutes of Health, these tests include a complete blood count (CBC), blood culture, stool culture, ELISA urine test, platelet count and florescent antibody study. If typhoid is diagnosed, electrolytes and antibiotics are given intravenously.

Prevention/Solution

• Vaccination can be given to prevent infection with typhoid. There are two vaccines, one given as a single dose injection, and another which is given orally over the period of several days. These vaccinations are highly recommended to those traveling outside of the industrialized areas of the world. Unfortunately, though they do significantly lower infection risk, vaccines are not completely effective against typhoid. Basic precautions should be taken to prevent ingestion of contaminated water when traveling.