All of the following are symptoms of typhoid except which option?

Appeared in: MP CHO -2019 (Shift-2)

Explanation

Seizures are not a characteristic or common symptom of typhoid fever.
They are considered a rare neurologic complication, typically occurring only in severe cases of the disease, often associated with typhoid encephalopathy.
The presence of seizures indicates a severe form of the illness with central nervous system involvement, not a typical presenting sign.

Option A: This is incorrect because abdominal pain is a common symptom of typhoid fever, reported in 21-40% of cases. It results from the inflammation of Peyer's patches in the ileum.
Option B: This is incorrect as a persistent, dull headache is one of the most frequent and earliest symptoms of typhoid, affecting up to 80% of patients.
Option C: This is incorrect because anorexia (loss of appetite) is a very common feature of typhoid fever, seen in 55-70% of patients, contributing to malaise and weight loss.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of Typhoid Fever as background academic context rather than a clinical decision trigger.
Recognizing the classic symptoms of fever, headache, and abdominal discomfort is crucial for a nurse to suspect typhoid fever, especially in a patient with a history of travel to an endemic area.
The development of a seizure in a patient with typhoid is a red flag for severe disease (typhoid encephalopathy) and requires immediate medical escalation, neurological assessment, and potentially intensive care.
What if? If the patient presented with fever, headache, and a stiff neck instead of abdominal pain, the differential diagnosis would broaden significantly to include bacterial meningitis, which also requires urgent investigation and treatment.

How to Approach the Question

First, identify the core concept of the question, which is the symptomatology of typhoid fever.
Note the keyword 'except'. This signals that you must find the option that is NOT a typical symptom.
Recall the common clinical features of typhoid fever. These include a step-ladder fever pattern, persistent headache, abdominal pain or discomfort, and loss of appetite (anorexia).
Evaluate each option against this knowledge. Abdominal pain, headache, and loss of appetite are all well-known, common symptoms.
Consider the remaining option, 'Seizure'. Seizures are related to the central nervous system and are not a primary symptom of an enteric infection like typhoid, but rather a rare and severe complication.
Therefore, 'Seizure' is the correct exception.

Concept Tested & Keywords

QX36C0XD_4XjEXCrdlS6AT

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1777-1779

E6 Medicine Harrison 22e Part 1 p. 1358-1360

E6 Medicine Davidson Principles Practice 24e p. 280-282

Practise the full MP CHO -2019 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.