It is a general infection usually affects the Digestive system by the bacterium salmonella Typhi, causing a generalized weakness, ladderlike fever, red spots on chest and abdomen, sweating, chills, delirium and in serious cases inflammation of the spleen and bone.
Typhoid fever also characterized by ulceration of the Peyer’s Patches that leads to erosion of the intestinal wall resulting to internal hemorrhage as manifested by the enlargement of the spleen (Spleenomegaly).
Despite the fact that the disease commonly affects the gastrointestinal system, the following body systems might as well be affected:
Mode of Entry – Fecal-oral route through infected urine and feces.
Mode of Transmission –
Typhoid Fever may be transmitted via Fecal-oral route through infected feces and urine of the patient.
Eating of contaminated foods like meat, eggs, shellfish and other meat and poultry products.
Ingestion of uncooked or undercooked foods.
Hands of infected persons.
Flies and other flying insects.
Consumption of contaminated water, milk and other dairy products.
Through convalescent carriers that continue to harbor organisms in their tissues for variable lengths of time
Source of infection: Contaminated food and water
Signs and Symptoms
1. Prodromal – stage wherein the patient may have a flulike symptom.
Constipation or diarrhea, vomiting
Abdominal pain due to ulceration of the Peyer’s patches
Feeling of unwellness
Ladder like curve body temperature
·Rose spots – Maculopapular rashes appear on chest or abdomen of patient usually appear on 7 – 12 days.
Typhoid state – A condition in which there is brain involvement resulting to “Typhoid Psychosis”.
The patient could have altered level of consciousness.
Coma state wherein the patient appears to stare without seeing and a vigil look.
Locomotive disturbance carphologia through picking up of linens
Sultus tendium observed through involuntary twitching of tendons part of wrist of the patient.
Hemoculture – confirmatory of typhoid (+) organism after 1 week
Widal’s test/ blood serum agglutination(+) end of 2nd week
Fecalysis – Done by swabbing the rectal area.
üAdvise the patient not to eat meat especially red meat 1-2 days prior to the test cause it may give a false positive internal bleeding result.
Typhi Dot test- new method on diagnosing typhoid fever to detect IgH, IgG
Use of enteric precautions
TSB for high fever
Increase fluid intake
Administration of prescribed medications
Monitor for possible complications
Decontamination of water sources milk pasteurization,
Immunization – vaccine of C.T. cholera typhoid,
Perforation of the intestine
Note that typhoid fever may relapse.
Chloramphenicol – 14 days
Amoxicillin – (oral) in case the patient is resistant to Chloramphenicol
Monitor CBC to detect Chloramphenicol toxicity
SE of Chloramphenicol: Bone depression
If with resistance to both, use trimethoprim-sulfamethoxazole as an alternative drug.
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