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What is the reason for recurrent typhoid?

Q: I had typhoid 2 years back; had a relapse an year back and once again have had a third relaspe recently. What do you think my problem is? I am a vegetarian and don't even eat eggs. My diet is low-salt, less spicy, very less oil and I drink only boiled water. Please advise some tests, which I can get done or what food I should I eat? It's becoming tough since I work in the night. I used to be very active some time back. Suggest me a good doctor in Hyderabad or a good hospital, even my doctor has got confused now I think. Is there something seriously wrong with me?

A:Typhoid fever is caused by Salmonella typhi a bacterium found in the infected human intestine. It is a strict human pathogen, not found in any other animal hosts. Bacteria colonise the small intestine of the infected human hosts. Asymptomatic long-term colonization occurs commonly in infected hosts. Infected typhoid patient and more frequently carriers are important reservoirs of infections for typhoid fever. Food handlers or cooks who become carriers are potentially dangerous to the community. Food, vegetables or water contaminated human faeces by S. typhi are the common sources of infection S. typhi infections occur when food or water contaminated by infected food handlers or due to poor personal hygiene is ingested. The infectious dose for S. typhi infections is low, so person-to-person spread is common. Relapse due to typhoid can occur, but it is not that common. Relapses are common if antibiotics are not taken for full 15 days. You suffering from relapse three times appears to be unusual. I wish to know whether typhoid you suffered 2 years back was really typhoid or any other condition? Was typhoid proved by blood culture or a serological test such a Widal during that time? Have you done any test recently to reconfirm that you are suffering from typhoid fever? I would advise to repeat a full laboratory tests including Widal test, blood culture etc. to confirm the diagnosis. The fever you are suffering, I strongly suspect, may be from other infectious conditions which should be ruled out carefully with adequate and essential laboratory tests.

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