HEALTH TIP OF THE DAY!!! => TYPHOID FEVER!!! Typhoid fever is also known simply as typhoid. It is a common worldwide bacterial disease transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica subsp. enterica , serovar Typhi. The disease has received various names, such as gastric fever, enteric fever, abdominal typhus , infantile remittant fever, slow fever, nervous fever and pythogenic fever. The name typhoid means resembling typhus and comes from the neuropsychiatric symptoms common to typhoid and typhus. Despite this similarity of their names, typhoid fever and typhus are distinct diseases and are caused by different species of bacteria. The occurrence of this disease fell sharply in the developed world with the rise of 20th-century sanitation techniques and antibiotics. >>> Signs and symptoms Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. Over the course of these stages, the patient becomes exhausted and emaciated. * In the first week, the temperature rises slowly, and fever fluctuations are seen with relative bradycardia ( Faget sign ), malaise, headache, and cough. A bloody nose (epistaxis ) is seen in a quarter of cases, and abdominal pain is also possible. There is a decrease in the number of circulating white blood cells ( leukopenia) with eosinopenia and relative lymphocytosis ; blood cultures are positive for Salmonella typhi or paratyphi. The Widal test is negative in the first week. * In the second week of the infection, patient lies prostrate with high fever in plateau around 40 °C (104 °F) and bradycardia (sphygmothermic dissociation or Faget sign), classically with a dicrotic pulse wave. Delirium is frequent, often calm, but sometimes agitated. This delirium gives to typhoid the nickname of nervous fever. Rose spots appear on the lower chest and abdomen in around a third of patients. There are rhonchi in lung bases. The abdomen is distended and painful in the right lower quadrant, where borborygmi can be heard. Diarrhea can occur in this stage: six to eight stools in a day, green, comparable to pea soup, with a characteristic smell. However, constipation is also frequent. The spleen and liver are enlarged (hepatosplenomegaly ) and tender, and there is elevation of liver transaminases . The Widal test is strongly positive, with antiO and antiH antibodies. Blood cultures are sometimes still positive at this stage. (The major symptom of this fever is that the fever usually rises in the afternoon up to the first and second week.) * In the third week of typhoid fever, a number of complications can occur: Intestinal haemorrhage due to bleeding in congested Peyers patches; this can be very serious but is usually not fatal. Intestinal perforation in the distal ileum: this is a very serious complication and is frequently fatal. It may occur without alarming symptoms until septicaemia or diffuse peritonitis sets in. Encephalitis Neuropsychiatric symptoms (described as muttering delirium or coma vigil), with picking at bedclothes or imaginary objects. Metastatic abscesses, cholecystitis , endocarditis and osteitis. The fever is still very high and oscillates very little over 24 hours. Dehydration ensues, and the patient is delirious (typhoid state). One third of affected individuals develop a macular rash on the trunk. Platelet count goes down slowly and risk of bleeding rises. By the end of third week, the fever starts subsiding (defervescence ). This carries on into the fourth and final week. >>> Transmission The bacterium that causes typhoid fever may be spread through poor hygiene habits and public sanitation conditions, and sometimes also by flying insects feeding on faeces. Public education campaigns encouraging people to wash their hands after defecating and before handling food are an important component in controlling spread of the disease. >>> Diagnosis Diagnosis is made by any blood , bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and H-flagellar ). >>> Prevention Sanitation and hygiene are the critical measures that can be taken to prevent typhoid. Typhoid does not affect animals, and therefore, transmission is only from human to human. Typhoid can only spread in environments where human feces or urine are able to come into contact with food or drinking water. Careful food preparation and washing of hands are crucial to prevent typhoid. There are two vaccines licensed for use for the prevention of typhoid: the live, oral Ty21a vaccine. >>> Treatment The rediscovery of oral rehydration therapy in the 1960s provided a simple way to prevent many of the deaths of diarrheal diseases in general. Where resistance is uncommon, the treatment of choice is a fluoroquinolone such as ciprofloxacin. Otherwise, a third-generation cephalosporin such as ceftriaxone or cefotaxime is the first choice. Cefixime is a suitable oral alternative. Typhoid fever, when properly treated, is not fatal in most cases. Antibiotics , such as ampicillin, chloramphenicol , trimethoprim- sulfamethoxazole, amoxicillin and ciprofloxacin, have been commonly used to treat typhoid fever in microbiology. Treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%. When untreated, typhoid fever persists for three weeks to a month. Death occurs in between 10% and 30% of untreated cases. In some communities, however, case-fatality rates may reach as high as 47%. >> Surgery Surgery is usually indicated in cases of intestinal perforation. Most surgeons prefer simple closure of the perforation with drainage of the peritoneum. Small-bowel resection is indicated for patients with multiple perforations. If antibiotic treatment fails to eradicate the hepatobiliary carriage, the gallbladder should be resected. Cholecystectomy is not always successful in eradicating the carrier state because of persisting hepatic infection. _______________________ => NB: FOR ANY HEALTH ADVICE, EDUCATION & QUESTIONS YOU WANT TO ASK ABOUT YOUR HEALTH or SOMEBODYS HEALTH, JUST SEND ME A MESSAGE ON FACEBOOK HERE SO THAT I HELP YOU OUT THE BEST WAY I CAN. Thanks!!! >> Another health tip comes tomorrow!!!
Posted on: Tue, 30 Sep 2014 07:37:11 +0000
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