|Written by Dr.Md.Redwanul Huq (Masum)|
|Thursday, 7 February 2013 5:48|
Causative agent of Typhoid fever:
Typhoid fever is caused by Salmonella typhi.
Signs-symptoms of typhoid fever:
In the first week:
- Fever, where temperature increases in a stepladder pattern for 4 or 5 days
- Diarrhea and vomiting (in children)
- Relative bradycardia
End of the first week:
- Rose red spots on the back and upper abdomen. These are maculo – popular rash which fade on pressure.
- Splenomegaly (Hepatomegaly can also be present)
- Abdominal distension with tenderness
End of the second week:
- Increased toxemia
Complications (Usually occurs in 3rd to 4th weeks):
- Perforation of typhoid ulcer in the small intestine
- Bleeding from typhoid ulcer.
Other complications :
- Within the abdomen-
- Splenic abscess
- Liver abscess
- In the CVS
- In Respiratory system- Pneumonia
- In CNS –
- Bacterial meningitis
- Peripheral neuropathy
- In Skeletal system –
- TC, DC- usually leucopenia occurs with relative lymphocytosis.[But in 2nd week – leukocytosis occurs]
- Blood for C/S – gold standard for diagnosis of enteric fever[in 1st week]
- Stool culture – in second week
- Urine culture – in third week
- Widal test – It is done in 2nd wk to see the rise of antibody titre
- Bone marrow examination.
Treatment of typhoid fever:
- Bed rest
- Maintenance of proper nutrition.
Ciprofloxacin – 500 mg twice daily for 14 days
Or, Ofloxacin -500mg twice daily for 14 days
Alternative choice is Ceftriaxone 1-2 gm IV 12 hourly for 10 -14 days
Drug of choice for treatment of typhoid in pregnancy – Ceftriaxone.
Prevention of typhoid fever:
- Avoid taking contaminated foods and drinks
- Take Typhoid vaccine in endemic areas.