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What are Typhoid Causes Diagnosis and Treatment?

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.

    Diagnosis of Typhoid

    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

    Doctor Shawna Reason, Virologist
    Dr. Shawna Reason
    Name: 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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