TYPHOID FEVER

 

 

  TYPHOID FEVER

Typhoid fever is the systemic bacterial infection mainly caused by salmonella only in human population.This disease is clinically characterized by insidious onset of sustained fever, severe headache,aneroxia, and rose spots on the trunk non productive cough and altered bowel habits.The enteric fever includes both typhoid and paratyphoid fever.

AGENT 

s.typhi is a major causeo of enteric fever.

INCUBATION PERIOD

usually 10-14 days 

MODE OF TRANSMISSION 

it is transmitted via the faecal oral route or urine oral routes . This takes directly through soiled hands contaminated with faeces or urine of cases or carriers or indirectly by the ingestion of contaminated water , milk foods or through flies .

CLNICAL FEATURE

first week 

        • Gradual onset high grade fever 

        • fever ascends in a stepladder pattern 

        • headache, malaise,cough 

        • abdominal pain 

        • constipation 

        • diarrhea vomiting

        • relative bradycardia 

Second week 

       • Fever reaches a plateau

       • patient toxic look 

       • pea-soup diarhhea

       • abdominal distension

       • splenomegaly 

Third week 

       • More toxic look 

       • continuous high grade fever 

       • delirium confusion 

       • marked abdominal distension

       •weight loss

       •complication may develop

   D/D

      • Tuberculosis

      • malaria 

      • kala Azar

      • brucellosis

      • lymphoma

Investigation

      • Stool culture 

      • urine culture

      • blood test 

      • CBC

TREATMENT 

General measure 

      • Bed rest 

      • good nursing care 

      • maintainance of bowel and bladder 

      • antipyretic for fever 

      • fluid and electrolyte balance

Specific measure

      • Ciprofloxacin

      • ceftriaxone 

COMPLICATIONS

      • Bowel perforation

      • GI bleeding

      • cholecystitis

      • pneumonia

      • myocardia

      • osteomyelitis

PREVENTIVE MEASURES

     • Educate public regarding the important of hand washing

     • dispose of human excreta in sanitary manner and maintain fly proof latrine 

     • use scrupulous cleanliness in food preparation and handling

     • pasteurize or boil all milk and diary product

     • identify and supervise typhoid Carriers by excluding from hand washing.

VACCINES

     • monovalent typhoid vaccine

     • bivalent- typhoid vaccine

     • TAB vaccine