Typhoid Effects on Lungs & Spread through cough: Doctor Answers your questions.

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Typhoid fever primarily affects your digestive system (enteric fever). However, the organism can spread to other organs through the lymphatic system and the blood.

Today we will provide you with evidence-based answers to the most common questions about the relation between typhoid fever and the lungs.

Does Typhoid affect your lungs?

Lung or pulmonary affection with typhoid fever is almost exclusively in the form of cough. Other rare complications are lung inflammation (acute lobar pneumonia or pneumotyphoid) and pleurisy.

Here are the frequencies of such complications according to research:

Cough (very common): in about 22% of cases (the frequency of cough reached 45% in some studies)
Pneumonia (rare): 0.9% to 0.1 %
Pleurisy and pleural affection (rare): about 1%.

1. Cough:

Cough is frequent with typhoid fever—about 22% of patients with typhoid fever (reference).

Cough is often dry and occurs as a separate symptom without pneumonia.

Having a cough with typhoid doesn’t your lungs are affected unless it is abnormally severe and associated with shortness of breath and high fever.

Productive cough (with yellowish mucus) is also an indication you need to see your doctor.

2. Lung infection (pneumonia or pneumotyphoid).

Infection of the lung with typhoid can occur but is very rare. Pneumonia (lung infection with typhoid) is about 1% in severe cases (Reference).

Pneumotyphoid affects only the severe cases of typhoid with high-grade fever.

The symptoms of typhoid pneumonia include:

The typical symptoms of typhoid with high-grade fever, abdominal pain, altered bowel habits, and severe headache.
Progressive shortening of breath (increasing over days).
Cough: often severe with colored sputum (yellowish).
Chest pain.
Rapid shallow breathing.
Sometimes, bloody sputum.

3. Pleurisy:

The pleura is a double-layered membrane that covers your lungs. Inflammation of the pleura causes chest pain when you breathe in or out.

Inflammation of the pleura ultimately leads to fluid accumulation between the two layers of the pleura, a condition called (pleural effusion).

Although rare, Pleurisy and pleural effusion occur with severe cases of typhoid fever. In one study, the rate of pleural effusion with severe typhoid fever with about 1.1% (7 out of 631 patients) (reference).

Mild pleurisy is probably common and can be the cause of chest pain with typhoid fever.

Is typhoid contagious through breathing or cough?

Typhoid primarily spreads through feces (stool). Less commonly, it can also spread through urine. No evidence suggests that typhoid transmits through cough or breathing.

Contamination of food or water with fecal matter (or urine) is the most common transmission route of typhoid fever.

Although cough is common with typhoid fever, spread through a cough or respiratory droplets is not documented.

In severe cases of typhoid fever, the organism can infect the lungs and cause pneumonia (pneumotyphoid).

We couldn’t find evidence supporting the spread of typhoid through cough or breathing in patients with pneumotyphoid. We need more research.

Is typhoid fever contagious through kissing or sex?

Casual kissing or sexual intercourse is not known to transmit typhoid fever infection. However, the salmonella organisms are shed through stool mainly. Certain sexual practices such as oral-to-anal sex can carry a risk of infection with typhoid fever.

Contamination of food, water, or utensils with the stool or urine of the infected individual can carry

Does typhoid cause difficulty breathing or a drop in your oxygen levels?

Typhoid fever can cause difficulty breathing by more than mechanism. The most common mechanism is the affection of your respiratory muscles (malaise and muscle aches).

Possible mechanisms of difficulty breathing with typhoid fever (reference):

Typhoid malaise (commonest): affection of your respiratory muscle (muscle aches or typhoid fatigue).
Inflammation of the lung lining (pleurisy): causes pain and difficulty breathing in or out. Pleurisy can turn into pleural effusion, which causes more difficulty breathing. Both pleurisy and pleural effusion are rare.
Typhoid pneumonia (very rare): A complication in severe cases; typhoid causes an infection of a lung lobe (lobar pneumonia or pneumotyphoid). In such a case, you can see a drop in your oxygen levels. Fortunately, the condition is infrequent, and it is unlikely to occur with proper treatment.
Heart affection (rare): Inflammation of the heart muscle (myocarditis) or the membrane enveloping the heart (pericarditis) can lead to difficulty breathing. It is also a very rare complication.

Can typhoid cause chest pain?

Typhoid fever can cause chest pain due to a variety of mechanisms. Most commonly due to malaise or muscle aches. However, other rare complications can cause chest pain, such as pleurisy, pneumonia, typhoid myocarditis, and pericarditis.