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What is carrier stage in typhoid?

Q: I am a 16 years old boy, who was admitted to the hospital a month ago due to typhoid. After ten days of admission, my body temperature came back to normal. But after that, I have been having vomiting and loose motions. I consulted the doctor who prescribed medicines. I got relief but after a couple of days, the problem recurred. Then again, I consulted the doctor and he told me that I might have gone in carrier stage. What is carrier stage? How to confirm it? If confirmed, how long does it take to cure?

A:Overall, 1-4% cases of typhoid fever can go into chronic carrier stage and can excrete bacteria in stool or urine up to a year. This stage usually occurs in subjects who are either not treated or partially treated. Importantly this state is asymptomatic. This can be diagnosed with positive culture from urine or stools. Treatment is with oral antibiotics based upon culture sensitivity report for a period of 4-6 weeks. In your case, you have been treated and have symptoms therefore; it is unlikely that you have carrier stage of typhoid / enteric fever. If your diagnosis was proper and has been partially treated, then it is possible that you still have some active infection. I would suggest you to undergo diagnostic tests for typhoid fever especially blood and stool culture, and Widal test to confirm the diagnosis. Other possibility is antibiotic induced diarrhoea, which can be treated with metronidazole (400 mg) thrice a day.

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