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EPIDEMIOLOGY
strongly endemic
endemic
sporadic cases
DEFINITION
The infection always comes from another human, either an ill person or a
healthy carrier of the bacterium. The bacterium is passed on with water and
foods and can withstand both drying and refrigeration.
HISTORY
Antonius Musa, a Roman physician who
achieved fame by treating the Emperor
Augustus 2,000 year ago, with cold baths
when he fell ill with typhoid.
ROSE SPOT
Relative Bradycardia
CAUSES
1. Caused by the bacterium Salmonella Typhi .
2. Ingestion of contaminated food or water.
3. Contact with an acute case of typhoid fever.
4. Water is contaminated where inadequate sewerage systems and poor sanitation.
5. Contact with a chronic asymptomatic carrier.
6. Eating food or drinking beverages that handled by a person carrying the bacteria.
7. Salmonella enteriditis and Salmonella typhimurium are other salmonella bacteria,
cause food poisoning and diarrhoea.
PATHOGENESIS
Ingestion of contaminated food or water
Salmonella bacteria
Invade small intestine and enter the bloodstream
Carried by white blood cells in the liver, spleen, and bone marrow
PATHOGENESIS
Bacteria invade the gallbladder, biliary system, and the lymphatic
tissue of the bowel and multiply in high numbers
Then pass into the intestinal tract and can be identified for
diagnosis in cultures from the stool tested in the laboratory
SYMPTOMS
No symptoms - if only a mild exposure;
some people become "carriers" of typhoid.
Poor appetite,
Headaches,
Generalized aches and pains,
Fever, Lethargy, Lethargy,
Lethargy,
Diarrhea,
Have a sustained fever as high as (39 to 40 degrees Celsius),
Chest congestion develops in many patients, and
abdominal pain and discomfort are common,
Constipation, mild vomiting, slow heartbeat and dicrotic pulse
Time frame
The condition may last for weeks or even a month or longer without
treatment.
Second stage
Second-stage typhoid fever is characterized by weight loss, high fever,
severe diarrhea and severe constipation. Also, the abdominal region
may appear severely distended.
Typhoid State
When typhoid fever continues untreated for more than two or three
weeks, the effected individual may be delirious or unable to stand and
move, and the eyes may be partially open during this time. At this point
fatal complications may emerge.
DIAGNOSIS
FELIX-WIDAL TEST
The test has only moderate sensitivity and specificity. It can be negative in up to 30%
S. typhi shares O and H antigens with other Salmonella serotypes and has cross-reacting
epitopes with other, Enterobacteriacae, and this can lead to false-positive results.
Despite these limitations the test may be useful, particularly in areas that cannot afford
the more expensive diagnostic methods
A quick and reliable diagnostic test for typhoid fever as an alternative to the
Widal test.
IDL Tubex test: can detect IgM O9 antibodies from patients within a few
minutes.
The detection of specific IgM within three hours suggests acute typhoid
infection.
Prevention
And
Treatment
TREATMENT
Consultations
Diet
The patient should be encouraged to stay home from work until recovery.
TYPHOID CARRIERS
some 15% of typhoid fever patients become chronic carriers.
S. typhi carriage, amoxicillin or ampicillin (100 mg per kg per day) plus
probenecid (1 g orally or 23 mg per kg for
children) or TMP-SMZ (160 to 800 mg twice daily) is administered for six
weeks;
About 60% of persons treated with either regimen can be expected to
have negative cultures on follow-up.
Clearance of up to 80% of chronic carriers can be achieved with the
administration of 750 mg of ciprofloxacin twice daily for 28 days or 400
mg of norfloxacin.