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Typhoid fever

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Typhoid fever

Typhoid fever, also known simply as typhoid, is a bacterial infection due to Salmonella typhi that causes symptoms which may vary from mild to severe and usually begin six to thirty days after exposure. The bacterium lives in the intestines and bloodstream of humans. It is spread between individuals by direct contact with the feces of an infected person. No animals carry this disease, so transmission is always human to human.

Cause of the disease

S. typhi enters through the mouth and spends 1-3 weeks in the intestine. After this time, it makes its way through the intestinal wall and into the bloodstream.From the bloodstream, it spreads into other tissues and organs. The immune system of the host can do little to fight back because S. typhi can live within the host’s cells, safe from the immune system. Around 1 in 4 cases of typhoid end in death if it is not treated. Thought it is treated about 4 of 100 cases are fatal.

Symptoms of typoid

Typhoid fever is divided into four distinct stages, each lasting about a week. The two major symptoms of typhoid are fever and rash. And also fever usually rises in the afternoon up to the first and second week

  • In the first week,
    • The body temperature rises slowly, and fever fluctuations are seen with relative bradycardia (Faget sign), malaise, headache, and cough.
    • It also causes leukopenia (Which the condition is lessen the count of white blood cells).
    • In some cases bloody nose can be seen and abdominal pain is also possible
  • In the second week,
    • The person is often too tired to get up, with high fever in plateau around 40 °C (104 °F)
    • Bradycardi classically with a dicrotic pulse wave. .
    • Rose spots appear on the lower chest and abdomen in around a third of patients.
    • Rhonchi are heard in lung bases.
    • Delirium is frequent,
    • The abdomen is distended and painful in the right lower quadrant, where borborygmi can be heard.
    • Diarrhea can occur in this stage
    • Constipation
    • The spleen and liver are enlarged and tender
  • In the third week
    • Intestinal haemorrhage due to bleeding in congested Peyer’s patches
    • Intestinal perforation in the distal ileum
    • Encephalitis
    • Respiratory diseases such as pneumonia and acute bronchitis
    • Neuropsychiatric symptoms
    • Metastatic abscesses, cholecystitis, endocarditis, and osteitis
    • The fever is still very high and oscillates very little over 24 hours
    • One-third of affected individuals develop a macular rash on the trunk.
    • Platelet count goes down slowly and risk of bleeding rises.
  • Other symptoms can include weakness, abdominal pain, constipation, and headaches; rarely, symptoms might include confusion, diarrhea, and vomiting (but not normally severe).

Note : paratyphoid has similar symptoms to typhoid but is caused by Salmonella enterica. Both conditions are of similar severity.

Some steps to avoid typhoid are

  • Ensure water is heated on a rolling boil for at least one minute before consuming
  • Aware of  eating anything that has been handled by someone else
  • Avoid eating at street food stands
  • Do not have ice in drinks

Diagnosis of Typhoid is by detecting the presence of Salmonella typhi, which is done by

  • Blood test
  • Urine test
  • Stool
  • Bone marrow sample

Treatment of typhoid

Treatment mainly with vaccination and antibiotics

Typhoid vaccination

  • Oral – live, attenuated vaccine. Consists of 4 tablets – one taken every other day, the last of which is taken 1 week before travel.
  • Shot – inactivated vaccine, administered 2 weeks before travel.Note: vaccines are not 100 percent effective and caution should still be exercised when eating and drinking.


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