Causes Diagnosis and Treatment of Typhoid
Typhoid fever caused by typhoid bacillus, patients with
persistent high fever (40 to 41 ℃) for more than 1
to 2 weeks in the typhoid epidemic season and regions, and have a special toxic
face, relatively slow pulse, skin roseola, hepatosplenomegaly.
The total
number of white blood cells in peripheral blood is low, eosinophils disappear,
and typhoid cells (ring
cells) are present in bone marrow, which can be clinically diagnosed as typhoid
fever.
English name: Typhoid
fever
Visiting department:
Infectious Diseases
Common causes: Caused by
Salmonella typhi
What are the Common symptoms of Typhoid?
High fever,
poisoned face, slow pulse, skin rash, liver and spleen.
Acute fever with
nausea, vomiting, diarrhea
Acute fever with
vomiting and diarrhea are more common in gastrointestinal infectious diseases
or acute poisoning, and have a history of eating unclean food.
Basic Information
English name: typhoid fever
Visiting department: Infectious Diseases
Common causes
Caused by
Salmonella typhi
Common symptoms
High fever,
poisoned face, slow pulse, skin rash, liver and spleen
Contagious: +
What are the Causes of Typhoid?
Typhoid bacillus has strong viability in nature, can survive
in water for 2 to 3 weeks, can maintain in the feces for 1 to 2 months, can not
only survive in milk, but can reproduce.
Low temperature resistance, can
survive for several months in a frozen environment, but has weak resistance to
light, heat, drying and disinfectants.
It will die if exposed to direct sunlight
for several hours. It will die after heating to 60 ° C for 30 minutes or
immediately after boiling. Chlorine can kill quickly.
What is the Clinical manifestation of Typhoid?
The incubation period is about 10 days, and its length is
related to the amount of infected bacteria.
The food-type outbreak can be as
short as 48 hours, and the water-borne outbreak can be as long as 30 days.
The
typical natural course of typhoid fever is about 4 weeks and can be divided
into 4 phases:
1. Initial stage
It is equivalent to the first week of the disease course.
Onset is mostly slow.
Fever is the earliest symptom. It is often accompanied by
general discomfort, fatigue, loss of appetite, sore throat, and cough.
The
condition gradually worsened, and the body temperature rose stepwise, reaching
39-40 ° C within 5-7 days.
There may be chills and fewer chills before fever,
and sweating is not significant when fever is reduced.
2. Extreme
It is equivalent to the second to third week of the disease
course, and often has the typical symptoms of typhoid fever, which is helpful
for diagnosis.
3. Remission period
Corresponding to the 3rd to 4th weeks of disease course, the
human body's resistance to typhoid bacteria gradually increased, body
temperature fluctuated and began to decline, appetite gradually improved,
abdominal distension gradually disappeared, and splenomegaly began to retract.
However, there is a risk of intestinal bleeding or intestinal perforation
during this period, and special vigilance is required.
4. Recovery period
The course began on the 4th weekend, and the body temperature
returned to normal, and the appetite improved, and generally recovered
completely in about 1 month.
Typhoid Diagnostic Test
Routine inspection
Most white blood cells are 3 × 109 / L - 4 × 109 / L, with
neutropenia and eosinophils disappearing, the latter gradually rising with the
improvement of the disease.
The eosinophils in the polar phase are > 2%, and
those with an absolute count exceeding 4 X 108 / L can basically exclude
typhoid fever. Mild proteinuria may be present at high fever. Fecal occult
blood test was positive.
2. Bacteriological examination
(1) Blood culture is the basis for diagnosis. It can be
positive early in the course of the disease.
The positive rate can reach 90% on
the 7th to 10th days, and it can be reduced to 30% to 40% in the third week.
It
is often negative in the fourth week.
(2) Bone marrow culture: The bone marrow culture rate is
higher than that of blood culture, which is especially suitable for those who
have been treated with antibiotics and have negative blood culture.
(3) The stool culture can be positive during the incubation
period, up to 80% at 3 to 4 weeks, and the positive rate drops rapidly at 6
weeks after illness, and 3% of patients can excrete bacteria for more than one
year.
(4) The positive rate at the end of the course of urine
culture can reach 25%, but fecal contamination should be avoided.
(5) Rose rashes or scrape biopsy of roseola can also be
positively cultured.
What is the Diagnosis for Typhoid?
Typhoid fever can be diagnosed clinically based on epidemiological
data, clinical manifestations and immunological examination results, but the
diagnosis of typhoid fever is based on the detection of pathogenic bacteria:
1. Clinical diagnostic criteria: There is persistent high
fever (40 to 41 ° C) for more than 1 to 2 weeks in the typhoid epidemic season
and regions, and there is a special poisoned face, relatively slow pulse, skin
roseola, hepatosplenomegaly, and peripheral blood.
The total number of white
blood cells is low, eosinophils disappear, and typhoid cells (ring cells) are
present in the bone marrow, which can be clinically diagnosed as typhoid fever.
2. Isolated typhoid bacteria from blood, bone marrow, urine,
feces, and roseola scrapes.
3. Specific antibody is positive, the "O" antibody
agglutination titer of the Fidelity reaction is greater than 1:80, the
"H" antibody agglutination titer is greater than 1: 160, and the
recovery period titer is increased by more than 4 times.
What is the Treatment for Typhoid?
General treatment and symptomatic treatment. After admission,
the patient is isolated according to infectious diseases of the digestive
tract. After the clinical symptoms disappear, the stool is cultured every 5-7
days.
The isolation can be released 2 times in a row. Patients with fever must
rest in bed.
They can sit in bed for 2 to 3 days after fever, and can move
slightly for 2 weeks after fever.
Should be given a high-calorie,
high-nutrition, digestible diet, including a sufficient amount of
carbohydrates, proteins and various vitamins to supplement the consumption
during the fever period to promote recovery, during the fever should be a
liquid or soft residue-free diet, a small number of meals.
After fever, after
appetite increases, you can gradually add porridge, soft rice, and avoid eating
hard and slag food, so as to avoid intestinal bleeding and bowel perforation.
Generally, the normal diet will be restored 2 weeks after fever.
Patients
should be encouraged to take in more water, about 2,000 to 3,000 ml per day
(including diet) to facilitate excretion of toxins. Those who cannot eat due to
severe illness can use intravenous infusion of 5% glucose saline.
People with severe toxemia can use hormones in combination
with a sufficient amount of effective antibacterial therapy.
Author's Bio
 |
| Dr. Shawna Reason |
Education: MBBS, MD
Occupation: Medical Doctor / Virologist
Specialization: Medical Science, Micro Biology / Virology, Natural Treatment
Experience: 15 Years as a Medical Practitioner
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