Typhoid fever | Treatment Symptoms Causes Prevention Ultimate Guide 2020

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Typhoid fever

What is typhoid fever?

Definition:

Typhoid fever is an acute infectious disease of S. Typhi with clinical features and characterized by lesion of Peyer’s patches of the intestine, bacteriemia, serve intoxication, enlarged liver, and spleen.

The word typhoid is taken from the Greek word whose meaning is “Smoke”. Typhoid Fever is caused by Gram-negative rod, bacteria known as Salmonella Typhi and Salmonella Paratyphi. It is also known as enteric fever, as bacteria lives in the intestine and bloodstream.

 It is spread between individuals by direct contact with the feces of an infected person.

The route of transmission is mainly orofecal. No transmitted through any animals always transmitted from person to person.

One may get confused with Typhoid fever and Typhus fever as both causes high fever, but one should focus on symptoms there are quite different symptoms. Typhus is spread by lice while typhoid fever is spread when food or water is contaminated by fecal matter. 

If typhoid fever is untreated it may cause fatal 1 in 5 cases. With treatment, the cases reduced to 4 in 100 cases causing fatal.

S. Typhi enters the body through the mouth and spends 1 to 3 weeks in the intestine. After this, it makes its way through the intestinal wall and enters the bloodstream.

From the bloodstream, it may spread into the tissues and organs like liver, gallbladder. The immune does not respond too much has S. Typhi can live within the host’s cells.

Typhoid fever may be diagnosed by detecting the presence of S. Typhi or Paratyphi bacteria via blood, stool, urine or bone marrow sample but commonly diagnosed is made by blood or stool.

Typhoid Fever symptoms:

Typhoid fever Symptoms normally appear in the intestinal phase within a week to 4 weeks after bacteria cause infection.

Blood cultures test is the standard diagnostic method. About 80 percentage of infectious cases have positive blood cultures. 

MacConkey agar is used to culture the S. Typhi is also helpful to find out S. Typhi infection.

The major typhoid fever symptoms are high-grade fever may range from 98 degrees Fahrenheit to 104 Fahrenheit while measuring in Celsius may range from 38 to 41-degree celsius.

The appearance of rashes on the neck abdomen rose-red color spots is another major symptom of S. Typhi.

Other Typhoid fever symptoms include:

  • Abdominal Cramps and Pain
  • Constipation may be diarrhea 
  • Headache
  • Malaise
  • Myalgia
  • Arthralgia
  • Anorexia

Complications:

Complications occur in 10-15 percent of patients, particularly those who have got an infection from weeks. 

Gastrointestinal Bleeding is the most common complication

others include:

  • Intestinal Perforation
  • Rising Pulse 
  • Falling Blood Pressure
  • Anemia
  • Hepatitis
  • Shock
  • Delirium
  • Cholecystitis
  • Meningitis
  • Psychotic stage
  • Impairment of coordination
  • Bronchitis
  • Focal Abscess

Typhoid Fever Causes

The major cause is S.typhi and spreads through food, drinks and contaminated water with infected fecal matters. Washing vegetables and other objects with contaminated water which is used by man can also cause the spreading of the disease.

Sometimes in some people are carriers of typhoid but symptoms do not appear because of many reasons.

People who are carriers may get a positive test of S. Typhi.

Also, Read about Blood Blister

Preventions

It is commonly found in water, ice, food, milk, and soil, where they may survive from 2 to 7 days but in Ice and Ice cream, the bacteria may survive a few weeks.

Use of hand wash. 

Use Pure water.

Selecting foods carefully when someone is living in developing countries.

Developing countries have made difficult to prevent the spreading of infection.

E.g: Poor farmers in some areas use human sewage as fertilizer or used contaminated water.

In addition, inadequate sewage systems are one of the common issues of developing countries.

Chemical treatment of the water supply is really helpful to reduce the incidence of S. Typhi infection, Chlorine is the chemical of choice for S. Typhi.

Be sure that the area and utensils you use for food preparation are clean before you use them.

The use of disinfectants may help to prevent the spreading of bacteria.

Used of vaccination.

Typhoid Fever Vaccination

Before 2019 there were many attempts were made to develop a vaccine for typhoid but no vaccine showed 100% effectiveness, therefore there was no vaccine at that time.

Recently Pakistan has developed a vaccine for typhoid fever as it is common in developing countries that are facing the challenges of typhoid, especially children.

Vaccination is helpful for a child ranging from 9 months to 15 years. 

Typhoid Fever Treatment

In areas of endemic disease, more than 60 to 90 percent of cases are managed at home with proper use of antibiotics and bed rest. For hospitalized patients, by taking effective antibiotics, good nursing care, adequate nutrition careful attention and balancing body’s homeostasis regarding fluid and electrolyte balance and prompt recognition and treatment of complications are necessary to avert death.

Medical staff should care about the mouth cavity also skin as well. 

In the feverish period, one should take care of his diet, the diet should have enough energy, but it must not affect the intestinal wall either mechanically or by its chemical properties.

Chloramphenicol is pretty effective, but wide usage of this antibiotic may lead to the appearance of resistant against it.

Other drugs used are:

  • Chloramphenicol 
  • Ceftriaxone
  • Cefoperazone 
  • Ciprofloxacin
  • Cefixime 
  • Norfloxacin
  • Ofloxacin
  • Pefloxacin
  • Enoxacin
  • Fleroxacin

The dose may vary from person to person according to age, sex however some time may vary from individual to individual.

Co-trimoxazole, Amoxycillin and furazolidone can also be used for the treatment of typhoid. Therefore treatment should be done by looking at adverse effects on the drugs.

There is strong evidence that the fluoroquinolones are the most effective drugs for the treatment of typhoid fever but other drugs can also be recommended according to side effects or clinical signs and symptoms.

Avoiding Infection

Contaminated water and food is the most common cause of spread, However, This can happen through an infected water source or when someone handling food improperly.

  • Hygiene food is necessary to avoid infection.
  • Bottled water should be used, therefore chlorinated water should be used.
  • If bottled water is not available to ensure to boil the water. So that bacteria can be killed easily.
  • Eating street food should be avoided Therefore one should always eat hygiene food is necessary.
  • Do not have ice in a drink as Bacteria can survive in ice more time than that of any other source.
  • Avoid eating raw fruits and vegetables or must wash it with pure water.

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