Investigations for typhoid and paratyphoid fevers

Before starting empirical therapy for typhoid and paratyphoid fevers, collect blood samples for culture.

For adults and children with sepsis or septic shock, start antibiotic therapy within 1 hour of presentation to medical care or, for ward-based patients, development of sepsis or septic shock. Antibiotics should be administered immediately after blood samples are taken for culture. For nonantibiotic management of sepsis, see Resuscitation of patients with sepsis or septic shock.

Do not delay antibiotic administration to collect stool samples for culture. For optimal culture sensitivity, collect 3 stool samples at 48-hour intervals. Rectal swabs can be collected for culture if a stool sample cannot be provided.

In neonates and children younger than 3 months with bacteraemia, perform cerebrospinal fluid (CSF) analysis to exclude neurological disease.