Gradual onset of chills and malaise, headache, anorexia, epistaxis, backache, and constipation}yy Usually occurring 10-15 days after infection}yy Abdominal pain and tenderness are prominent features}High fever > 38°C}Delirium and stupor in advanced stages}Tender splenomegaly, relative bradycardia, cough}Complications may include perforation of the gut with peritonitis, gastrointestinal hemorrhage