0 Typhoid Fever

DEFINITIONS

Typhoid fever is an infection caused by the bacterium Salmonella typhi.
CAUSE

Bacterium Salmonella typhi.


Typhoid bacteria found in feces and urine in patients.
The spread of bacteria into the food or beverage can occur due to the lack of washing hands thoroughly after defecation and after micturition.
Flies can spread the bacteria directly from feces to food.

The bacteria enter the digestive tract and get into the blood circulation. This will be followed by the occurrence of inflammation of the small intestine and large intestine.
In severe cases, which can be fatal, the affected tissue can have bleeding and perforation.

Approximately 3% of patients infected by Salmonella typhi and not get treatment, the bacteria would be found in stool for more than a year.
Some of the carriers of these bacteria showed no symptoms of typhoid fever.
SYMPTOMS

Usually symptoms begin gradually in wakatu 8-14 days after infection.
Symptoms may include fever, headache, joint pains, sore throat, constipation, decreased appetite and abdominal pain.
Sometimes patients feel pain when urinating and there was coughing and bleeding from the nose.

If treatment is not started, then the body temperature will slowly rise in the next 2-3 days, reaching 39.4 to 40? Celsius for 10-14 days. The heat started to decline gradually at the end of the third week, and returned to normal in the fourth week.
Fever is often accompanied by a slow heartbeat and fatigue.

In severe cases could occur delirium, stupor or coma.

In approximately 10% of patients arise a group of small spots of pink on the chest and abdomen during the second week and lasted for 2-5 days.


COMPLICATIONS

Most patients experienced complete healing, but complications can occur, especially in patients with untreated or if treated too late:
- Many patients experiencing intestinal bleeding; approximately 2% experienced severe bleeding.
Usually bleeding occurs in the third week.

- Intestinal perforation occurs in 1-2% patients, causing severe abdominal pain due to intestinal contents ronga infect the abdomen (peritonitis).

- Pneumonia can occur in second or third week and usually occur due to pneumococcal infection (although the typhoid bacterium can also cause pneumonia).

- Infections of the bladder and liver.

- Blood infection (bacteraemia) sometimes cause bone infections (osteomyelitis), infection of heart valves (endocarditis), infection of the lining of the brain (meningitis), infection of the kidney (glomerulitis) or urinary-genital tract infections.

In approximately 10% of untreated cases, early symptoms of infection arise again within two weeks after the fever subsided.

DIAGNOSIS

Diagnosis based on symptoms and physical examination.

To confirm the diagnosis, performed blood cultures, feces, urine or other body tissues in order to find a bacterial cause.

TREATMENT

With appropriate antibiotics, more than 99% of patients can be cured.
The most used antibiotic chloramphenicol Sometimes the food is given through an IV until the patient can digest food.
In case of intestinal perforation, given broad-spectrum antibiotics (for various types of bacteria will get into the abdominal cavity) and may need surgery to repair or lift the perforated bowel.

PREVENTION

Per-oral typhoid vaccine (oral) provides protection for 70%.
The vaccine is only given to people who have been exposed by the bacterium Salmonella typhi and the people who are at high risk (including laboratory workers and travelers).

The travelers should avoid eating raw vegetables and other foods served or stored at room temperature.
They should choose foods that are still hot or frozen foods, drinks cans and fruit can be peeled-skinned.