Abstract
Typhoid fever is a systemic febrile illness caused by Salmonella Typhi. In developed countries, the diagnosed cases are almost solely imported ones.
Typhoid fever is endemic especially on the Indian subcontinent, in South-Eastern Asia, Africa, South and Central America. The authors are presenting two case reports of typhoid fever imported from India: a 59-year old female tourist and a 16-year old male who has visited his relatives.
The presented case reports emphasise the pitfalls in the diagnostics and treatment of the enteric fever. For the confirmation of the typhoid fever it is necessary to isolate bacteria from blood, stool or urine.
Due to its low sensitivity and specificity the Widal test is insufficient for diagnostic purposes. The treatment is complicated by the emergence of multi-drug resistant strains and strains with reduced susceptibility to fluoroquinolones.
The article presents the potential preventive measures, with the emphasis on vaccination. The efficacious whole-cell vaccines are no longer routinely used due to their substantial reactogenicity.
Live-attenuated and polysaccharide vaccines represent well-tolerated vaccines despite their slightly lower effectiveness when compared to the above mentioned whole-cell vaccines. Vi-conjugated vaccines have been recently developed, with high probability to provide protection also in children under 2 years of age.