TYPHOID FEVER ?
It’s otherwise known as Enteric Fever ?.
Salmonella typhi (paratyphoid:-Salmonella paratyphi).
Feaco-oral, Sexual transmission
Fever that gradually increases over several days; Fever, headache, relative bradycardia, splenomegaly, cough, rose spots, and diarrhea or constipation; Constipation early & diarrhea late in disease.
Serious complications include intestinal hemorrhage and perforation that usually occur 2-3 weeks into the illness. Possible complications include blood in stool, cholecystitis, intestinal perforation, pneumonia, osteomyelitis, endocarditis, meningitis, skin abscesses, glomerulitis, genitourinary tract infection, and shock. Intestinal hemorrhage and perforation are the major complications seen in patients with disease lasting more than 2 weeks. Endocarditis is rare. Meningitis occurs mainly in infants and children. Brain abscesses occur in adults, but rarely. Epididymitis has been reported.Intestinal perforation occurs in 0.5% to 1% of patients. Other complications are septic shock, bleeding diathesis, hepatitis (with or without jaundice) and abscesses (brain, liver, and spleen). Septic arthritis occurs rarely. CNS infections can cause extraocular palsies.
Hand washing,maintain hyegeine, vaccine available both injectable and oral vaccine. Booster doses required every 2yrs (injectable vaccine) and every 5yrs (oral vaccine).
Care for patients (fecal-oral pathogens)
Consume unpasteurized milk/cheese
Eat undercooked meat or fish
Fail to complete immunizations
Ingest infectious agents in food/water
Travel to endemic area
Work in a medical or research lab
Culture of blood (early), urine and feces (after first week) and bone marrow (most sensitive); Serology (Widal) not useful; Serology not sens & not spec.; Blood cultures are 40% to 80% sensitive.
Given in the table
Dr Atul Chowdhury