Paratyphus

Notifiable infection with Salmonella parathyphi.

Incidence: 0.1-0.2/100,000 population/year (mostly in patients coming from poorer countries)

• Pathogen
  • Salmonella paratyphi.
• Incubation period
  • 1-10 days.

• Reduced general condition, fever, diarrhoea, vomiting, nausea, abdominal pain and sometimes jaundice.
• In the course, development of a maculopapular, truncal exanthema, which eventually spreads to the upper and lower extremities (palmoplantar recess).
• An association with herpes simplex labialis is possible.

Blood culture

Stool sample

• The vaccine for typhoid fever provides some protection against paratyphoid fever

• Good prognosis.
• Up to 5% of patients become permanent excretors.

• Ciprofloxacin p.o 500 mg 2x tgl. for 2 weeks.
• Alternatively: Ceftriaxone i.v. 2g 1x tgl. for 2 weeks.
• Alternatively: Cotrimoxazole (Sulfamethoxazole/Trimethoprim) p.o. 800/160mg 2x tgl.

Permanent excretors

• Ciprofloxacin p.o 500 mg 2x tgl.. for 4 weeks.
• Alternatively: Cotrimoxazole (Sulfamethoxazole/Trimethoprim) p.o. 800/160mg 2x tgl

1. Elhadad D, Desai P, Grassl GA, McClelland M, Rahav G , Gal-Mor O. Differences in Host Cell Invasion and Salmonella Pathogenicity Island 1 Expression between Salmonella enterica Serovar Paratyphi A and Nontyphoidal S. Typhimurium. Infect Immun 2016;84:1150-65.
2. Duchatel JP, Jauniaux T, Smyth J, Habsch I, de Bournonville M, Losson B et al. Effect of a commercial paratyphus vaccine on the development of pigeon circovirus infection in young pigeons (Columba livia domestica). J Avian Med Surg 2010;24:107-14.
3. Fey H. [Proposal for a mass serological survey of our foreign workers for typhus and paratyphus B at the border]. Pathol Microbiol (Basel) 1965;28:626-31.
4. Fromme W , Woort-Kerkhoff J. [Observations on a paratyphus epidemic in a hospital]. Offentl Gesundheitsdienst 1956;18:297-302.