Clinical Spectrum and Outcomes of Typhoid Fever: A Retrospective Study

Background Typhoid fever remains a major public health concern in endemic regions, characterized by diverse clinical manifestations and significant morbidity and mortality. Objective To evaluate the clinical spectrum, complications, and outcomes of patients with typhoid fever. Methods This retrospective study was conducted at Shalamar Hospital, Lahore, Pakistan, from April 2022 to April 2025. A total of 305 patients with confirmed typhoid fever were included in the study. Patients were diagnosed through blood cultures or serological testing. Demographic information, presenting features, laboratory parameters, complications, treatment modalities, and outcomes were documented using a structured proforma. Results The mean age of patients was 22.6 ± 11.4 years, with a male-to-female ratio of 1.4:1. Fever was universal in 305 (100%), followed by abdominal pain in 189 (62.0%), loss of appetite 132 (43.3%), headache 123 (40.3%), diarrhea 106(34.8%), and constipation 74 (24.3%). Hepatomegaly and splenomegaly were observed in 92 (30.1%) and 68 (22.3%) of cases, respectively. Blood cultures were positive in 238 (78.0%) of patients, with Salmonella Typhi identified in 196 (64.3%). Complications occurred in 84 (27.5%) of patients, most commonly gastrointestinal bleeding 32 (10.5%) and intestinal perforation 21 (6.9%). The majority of patients recovered 287 (94.1%), while morbidity persisted in 9 (3.0%), and mortality was recorded in 9 (2.9%), mainly due to perforation and septicemia. Conclusion Typhoid fever continues to affect young populations disproportionately and presents with a broad spectrum of clinical features. Although most patients recover with appropriate treatment, complications remain frequent and contribute to significant morbidity and mortality.