Rose spots are a rash associated with typhoid fever caused by exposure to Salmonella Typhi. The rash is accompanied by fever, abdominal discomfort, and fatigue. Antibiotic therapy is the first course of treatment, and delayed or no treatment can cause life-threatening complications.
Rose spots are a rash associated with an acute typhoid infection. Commonly known as typhoid fever, the infection is caused by exposure to the bacteria Salmonella Typhi. Highly contagious, the infection is most often found in dirty water and, later, in food supplies contaminated by contaminated water. If treated promptly and appropriately, most people with typhoid fever make a full recovery. If left untreated, typhoid fever can lead to serious complications, including organ failure and death.
Pink-colored spots, which can range from light pink to reddish pink, vary in size and usually develop within the first week of a typhoid infection. Generally, the pink spots remain localized on the lower abdomen and upper legs. Fever, abdominal discomfort, and fatigue generally accompany rose spots. As the infection worsens, individuals may develop a sore throat and diarrhea. It is not uncommon for a serious infection to induce hallucinations, confusion and delirium in some people.
Despite its namesake, Salmonella Typhi is not responsible for other forms of enteric or intestinal fever. Unsanitary conditions, such as can be found in developing countries, provide the perfect environment for bacteria to grow. Insufficient sanitation and improper sanitation perpetuate the spread of bacteria. Individuals who travel to places where typhoid fever is known to exist are considered to be at increased risk of rose spots and infection.
Once Salmonella Typhi is introduced into the body, it travels to the intestines where it infiltrates the intestinal lining. In the absence of treatment, the bacterium spreads to other parts of the body where it reproduces and is eventually expelled, in part, with the faeces. Depending on the severity of the infection, the individual may experience a mild infection, known as paratyphoid fever, or more severe signs associated with typhoid fever.
A diagnosis of typhoid fever is generally made based on the presentation of symptoms. Since rose spots are one of the first signs, a diagnosis can be made before diagnostic tests. To confirm a diagnosis, a culture of the individual’s stool is usually done. Further tests may include a blood draw to assess the extent of Salmonella Typhi bacteria present. A high white blood cell count, which occurs when there is an infection, and a low blood platelet count are markers associated with typhoid fever.
Antibiotic therapy is the first course of treatment for pink spots and typhoid fever. Typhoid fever has adapted over the years and there are now strains that prove resistant to some antibiotics. Therefore, identification of the bacterial strain from a culture is essential to ensure that the right antibiotic is prescribed. Intravenous fluids, including electrolytes, are also given to treat and prevent further dehydration. Because typhoid can be spread through person-to-person contact, hospitalization is often required until antibiotic treatment is established and symptoms are relieved.
Delayed or no treatment for typhoid fever can cause life-threatening complications. Among the most common complications is intestinal perforation, which occurs when intestinal tissue weakens from the effects of Salmonella Typhi and ruptures or tears. If intestinal perforation occurs, the individual is at risk of sepsis, or blood infection, due to the introduction of bacteria into the bloodstream. Ultimately, organ function becomes significantly impaired and can lead to organ failure and death.
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