Your doctor is likely to suspect typhoid fever based on your symptoms and your medical and travel history. The diagnosis is usually confirmed by identifying Salmonella typhi in a culture of your blood or other body fluid or tissue. For the culture, a small sample of your blood, stool, urine or bone marrow is placed on a special medium that encourages the growth of bacteria. The culture is checked under a microscope for the presence of typhoid bacteria. A bone marrow culture often is the most sensitive test for Salmonella typhi. Although performing a culture test is the most common diagnostic test, another testing may be used to confirm a suspected typhoid fever infection, such as a test to detect antibodies to typhoid bacteria in your blood, or a test that checks for typhoid DNA in your blood. In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance. In fact, antibiotic-resistant bacteria are becoming more common, especially in the developing world. In recent years, Salmonella typhi has also proved resistant to trimethoprim-sulfamethoxazole, ampicillin and ciprofloxacin.

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