Typhoid Fever | Symptoms | Treatment | Expert Homeopathy

Typhoid Fever

Definition
It is caused by salmonella typhi and paratyphi, spread through water contaminated with human excreta by files, by carriers through contamination of food, mild or water...


Symptoms / Signs
First week
  • Onset is insidious
  • Temperature rises in a stepladder manner for the first 4-5 days. The temperature continues high 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 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 doughy feeling
  • Spleen enlarged 2-3 fingers and soft
  • Liver may be just palpable

Fourth week
  • Patient becomes increasingly ill and may pass into coma or die
  • Hemorrhage from perforation of peyer's patches may occur

If recovers
Temperature falls, appetite returns, distension disappears and strength improves.

Relapse
After recovery, relapse may occur.


Investigations
  • Blood culture: Positive in 95% in first week
  • Stool culture: Positive second or third week
  • Widal 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

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.

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 tox 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 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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