Typhoid fever

Complications of typhoid fever

Complications caused by typhoid fever usually only occur in people who have not been treated with antibiotics.

In such cases, about 1 in 10 people will experience complications, which usually develop during the third week of infection.

The two most common complications that can occur in untreated typhoid fever are:

  • internal bleeding in the digestive system
  • perforation (splitting) of a section of the digestive system or bowel, which spreads the infection to nearby tissue

These are described in more detail below.

Internal bleeding

Most internal bleeding that occurs in typhoid fever is not life threatening, but it can make you feel very unwell.

Symptoms include:

  • feeling tired all the time
  • breathlessness
  • pale skin
  • irregular heartbeat
  • vomiting blood
  • passing stools that are very dark or tar-like

blood transfusion may be required to replace any lost blood, and surgery can be used to repair the site of the bleeding.


Perforation is potentially a very serious complication. This is because bacteria that live in your digestive system can move into your stomach and infect the lining of your abdomen (the peritoneum). This is known as peritonitis.

Peritonitis is a medical emergency because tissue of the peritoneum is usually sterile and germ-free. Unlike other parts of the body, such as the skin, the peritoneum does not have an inbuilt defence mechanism for fighting infection.

In cases of peritonitis, an infection can rapidly spread into the blood (sepsis) before spreading to other organs. This carries the risk of multiple organ failure and, if it is not treated, death. The most common symptom of peritonitis is sudden abdominal pain that gets progressively worse.

Peritonitis requires admission to hospital where you will be treated with injections of antibiotics to get rid of the infection. Surgery will then be used to seal the hole in your stomach wall.

Read more about treating peritonitis.

Last updated: 31 January 2012

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