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.