Some observations seen in this fever are:
1. Massive loss of lean body mass or muscle due to tissue breakdown (250-500 g muscle tissue is lost/day) leading to excessive nitrogen losses.
2. Body stores of glycogen are quickly depleted because of increased energy requirements.
3. The gastrointestinal tract is highly inflamed and irritable as the seat of typhoid infection is the Peyer's patches of the intestine. The bacteria attaches to the epithelium of the intestinal wall, penetrates and multiplies in the mesenteric lymph nodes, eventually reaching the blood stream which in turn leads to secondary infection of the intestines.
4. Excessive diarrhoea, vomiting and perspiration can cause a lot of fluid and electrolyte losses.
5. Inflammation of GI tract can lead to intestinal ulceration and bleeding.