TYPHOID FEVER

: Concept
Typhoid and paratyphoid called ( ENTERIC FEVER)
Bacterial infectious disease ; aerobic bacilli gram negative salmonella
typhi
Faecal Oral route transmission
Common manifestation is persistant fever
Sourse infection infected excreta of carrier' contaminated food'
milk 'house flies
Pathology: after ingestion food that contaminated through GIT
system initial localize
In lymphoid tissue small intestine(payers patches) then become
inflamed and
Ulcerative sequence either heal or bleed or perforate
: Clincil
First week: fever paterrn continuous step ladder high grade
Pulse relative bradycardia‫ؤ‬Signs of bronchitis cough is common
Genral symptoms bacteremia headche'anorixia' polyartharalgia
GIT symptoms constipation adult ; diarrhea and vomting
(pediatric) tongue coated
Typhoid tongue
Second week: temperature high with change level of
consciousness (cloudy)
per abdomen examination :spleen soft 'enlarged'.tender
tenderness in RIF
rash rose spot
:third week: either recovery mild cases or complicated
meningitis 'intestinal bleeding' perforation' death
fourth week: recovery (signs) temperature subsided'normal
pulse' tongue clear
appetite normalized
relapse after 10 days
carrier
:complication
metearism
bleeding l lowerGIT
perforation
septicaemia
pneumonia
osteomyelitis
meningitis
myocarditis
arthritis
:investigation
CBC WBC relative leukopenia
Definitive diagnosis
Blood culture first week
Stool culture second week
Serology test may help for diagnosis widal test
Preventive mangment
treatment