Definition
It is caused by salmonella typhi and paratyphi, spreading through water contaminated with human excreta by files, by carriers through contamination of food, mild or water.
Cause
Typhoid fever is brought about by a sort of microorganisms called Salmonella typhi.
This isn't the very microscopic organisms that cause salmonella food contamination, however they are connected.
How the contamination spreads?
The Salmonella typhi microscopic organisms will be in the crap of a contaminated individual after they have been to the latrine.
In the event that they don't clean up as expected subsequently, they can sully any food they contact. Any other person who eats this food may likewise become contaminated.
Less normally, the Salmonella typhi microorganisms can be dropped in a contaminated individual's pee.
Once more, assuming a tainted individual handles food without cleaning up appropriately after peeing, they can spread the disease to another person who eats the polluted food.
In areas of the planet with unfortunate disinfection, tainted human waste can defile the water supply.
Individuals who hydrate or eat food washed in defiled water can foster typhoid fever.
Alternate ways typhoid fever can be contracted include:
Utilizing a latrine tainted with microscopic organisms and contacting your mouth prior to cleaning up
eating fish from a water source tainted by contaminated crap or pee
eating crude vegetables that have been treated with human waste
defiled milk items
having oral or butt-centric sex with an individual who's a transporter of Salmonella typhi microbes
What the microscopic organisms mean for the body
After eating food or drinking water debased with the Salmonella typhi microbes, the microorganisms drops into the stomach related framework, where they will rapidly duplicate.
This triggers a high temperature, stomach torment and clogging or loose bowels.
Left untreated, the microscopic organisms can get into the circulatory system and spread to different region of the body.
This can make the side effects of typhoid fever deteriorate during the weeks after contamination.
In the event that organs and tissues become harmed because of the disease, it can cause serious entanglements, for example, inner draining or a part of the bowel open.
Symptoms / Signs
First week
- Onset is insidious
- Temperature rises in a stepladder manner for the first 4-5 days. The temperature continues to be higher at night than in the morning.
- Malaise, headache, drowsiness and aching in limbs
- Cough and epistaxis may be present
- Constipation, loss of appetite, lassitude etc.
- Relative bradycardia is characteristic
- Tongue coated with red margin and tip
- At the end of the first week-Typical rash appears on the upper abdomen and on the back. They are sparse, raised rose-red, fading on pressure, disappearing after 2-3 days
- Spleen is palpable and soft at the end of the first week.
- Spleen is palpable and soft at the end of first week
Second week
- Temperature is continuous, but it is high with little variations.
- Spleen becomes palpable, soft, not more than 2 fingers
- Distended abdomen with t95%%enderness in right iliac fossa
- Pea soup stools 4-6 stools/day, watery, foul smelling
Third week
- The headache disappears, and the patient becomes profoundly ill at the end of the 2nd week. Some may be delirious
- Pulse shows tachycardia
- Tongue is coated and dry
- Abdomen is distended and tender on palpation, with a doughy feeling
- Spleen 2-3 fingers and soft
- Liver may be just palpable
Fourth week
- The patient becomes increasingly ill and may pass into coma or die.
- Hemorrhage from perforation of peer's patches may occur
If recovers
Temperature falls, appetite returns, distension disappears and strength improves.
Relapse
After recovery, a relapse may occur.
How to diagnose?
- Blood culture: Positive in 95% in first week
- Stool culture: Positive second or third week
- Vidal test: Positive second week onwards
- W.B.C count: Leucopenia with neutropenia
Complications
- Hemorrhage and perforation leading to peritonitis at the end of 2nd week or in 3rd week
- Septicemia, Pneumonia, Myocarditis, Myositis
- Arthritis
- Meningitis
- Cholecystitis
- Toxic typhoid psychosis
- Pancreatitis
- Osteomyelitis
- Hepatitis
- Bronchitis
- Meningismi
Differential diagnosis
- Tuberculosis
- Malaria
- Kalazar
- Infective endocarditis
- Brucellosis
- Lymphoma
- Fever
Typhoid fever Vaccines
In the UK, the 2 primary antibodies accessible to forestall typhoid fever are:
Vi immunization - given as a solitary infusion
Ty21a antibody - given as 3 containers to require on substitute days
Treatment
- Patient should be isolated
- Ice caps for fever beyond 102℉ and above 105℉ rub body with ice
- Severe cases should be hospitalized
- Bed rest
- Absolute rest in bed, using bed-pan, daily sponging and mouth gargling with salt water is necessary.
- Skimmed milk, whey, and fruit juice [if there is no diarrhea] during the onset may be given.
- At normal temperature, rice, soft pulp of bread, sago, fish, raw or half-boiled potatoes may be allowed.
Clinic confirmation is typically suggested in the event that you have serious side effects of typhoid fever, like tenacious regurgitating, extreme loose bowels or an enlarged stomach.
As a safeguard, small kids who foster typhoid fever might be owned up to a medical clinic.
In clinic, you'll have anti-infection infusions, and you may likewise be given liquids and supplements straightforwardly into a vein through an intravenous trickle.
Medical procedure might be required in the event that you foster perilous difficulties of typhoid fever, for example, inside draining or a segment of your stomach related framework parting.
Be that as it may, this is extremely uncommon in individuals being treated with antimicrobial.
A great many people answer well to clinic treatment and work on inside 3 to 5 days, yet it could be a little while until you're all around ok to leave medical clinic.
Homeopathic medicines: Treatment, general and prophylactic
Typhoidinum 30:
1] If taken by mouth during an epidemic regularly for some days, gives immunity from this infection for the time being.
2] Absolute rest in bed, using bed-pan, daily sponging and mouth gargling with salt water is necessary.
3] Skimmed milk, whey, and fruit juice [if there is no diarrhea] during the onset may be given.
4] At normal temperature, rice, soft pulp of bread, sago, fish, raw or half-boiled potatoes may be allowed.
Curative
Typhoidinum: This homeopathic preparation has been successfully employed by Dr. Watters of America in higher potencies; only, the lower ones aggravate the symptoms. This is not only curative, but preventive too. No indications, however, have been mentioned except that it suits typhoid infections.
Baptisia, Arnica, Rhus Tox:
These three typhoid remedies have some common symptoms, and so must be distinguished from one another before being selected. Arnica and Baptisia have common symptoms of :
a] Drowsy stupid state
b] Feeling of hardness of bed
c] Bruised and sore sensation all over the body
d] Restlessness
Rhus tox and Baptisia have in common a black or brownish coated tongue and symptoms numbered [c] and [d] with this difference that the restlessness of Baptisia is mental, while that of Arnica and Rhus to is physical.
Others medicines are: Muriatic acid, Lachesis, Opium, Hyoscyamus, Gelsemium, Kali phos.
Vaccinum myrtillus Q: For frequent yellow loose stools, great thirst and chilliness. This drug, if given early during the disease, i.e., in the 1st week, will arrest the temperature on the first day. On the second day, there will be a fall of temperature; on the third day, there will be a gradual remission of temperature and full remission within 5 days. [Dose 5 to 10 drops in water, 4 to 5 times daily].
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