MEDICAL SURGICAL NURSING-I

UNIT NO:XII

NURSING MANAGEMENT OF PATIENT WITH

COMMUNICABLE DISEASES

TYPHOID FEVER

MRS.S.TAMIL SELVI MSC(N),

PROFESSOR.

.
 LEARNING OBJECTIVES

At the end of the class students will be able to

-Describe the definition, incidence and epidemiology of typhoid fever

-List down the etiology and mode of transmission of typhoid fever
-Understand the path physiology and clinical manifestation of
typhoid fever
- Enumerate the laboratory diagnoses of typhoid fever
-State down the complication of typhoid fever
- List down the treatment, nursing management ,health education and
preventive measures
 INTRODUCTION
The typhoid infection is often passed on through
contaminated food and drinking water, and it is more
prevalent in places where hand washing is less frequent. It
can also be passed on by carriers who do not know they carry
the bacteria.
If typhoid is caught early, it can be successfully treated with
antibiotics; if it is not treated, typhoid can be fatal.
 DEFINITION

An acute illness with fever caused by infection with the salmonella

typhi bacteria contracted from contaminated water and food. Also
called enteric fever, bilious fever.

An infectious bacterial fever with an eruption of red spots on the

chest and abdomen and severe intestinal irritation.

A communicable disease marked especially by fever, diarrhea,

prostration, headache, and intestinal inflammation and caused by a
bacterium (Salmonella typhi)
 EPIDEMIOLOGY

• Typhoid fever remains an important public health problem in the

world especially in the impoverished population from developing
countries.
• Globally, the disease is estimated to cause 220,000 deaths and 22
million illnesses per year, predominantly in children of school-age or
younger.
 ETIOLOGY
1. Bacteria
Virulent bacterium that cause illness called
salmonella typhi

2. Fecal-oral route
Spread through contaminated food, water,
fingers and flies and occasionally through direct contact with
someone who is infected.

3. Typhoid carriers
These people called chronic carriers, shed
the bacteria in their faeces and are capable of infecting others
 MODE OF TRANSMISSION

water
Mouth
Foods of well
Faeces and
soil raw or perso
Urine from
cooked ns
Cases and
flies
carriers

fingers
PATHOPHYSIOLOGY
 SIGNS AND SYMPTOMS

• Fever that starts low and increases daily, possibly reaching as high as
104.9 F (40.5 C)
• Headache.
• Weakness and fatigue.
• Muscle aches.
• Sweating.
• Dry cough.
• Loss of appetite and weight loss.
• Abdominal pain
• poor appetite
• Skin rash with rose spot
 DIAGNOSTIC EVALUATION

BLOOD CULTURE
A blood culture during the first week of the fever can show a
solmonella typhi bacteria.

COMPLETE BLOOD COUNT(CBC)

A complete blood count(cbc) will show a high number of white blood
cells

STOOL CULTURE
Stool culture may be positive for salmonella typhi several days after
ingestion of the bacteria.

WIDAL TEST
Test where by bacteria causing typhoid fever are mixed with serum
containing specific antibodies obtained from an infected individual
 COMPLICATION

common complications in untreated typhoid fever are:

• internal bleeding in the digestive system
• splitting (perforation) of a section of the digestive system or bowel,
which spreads the infection to nearby tissue.

INTERNAL BLEEDING
Symptoms include
• feeling tired all the time
• breathlessness
• pale skin
• an irregular heartbeat
• vomiting blood
• stools that are very dark or tar-like
• A blood transfusion may be required to replace lost blood, and
surgery can be used to repair the site of the bleeding.
Perforation
• Perforation is potentially a very serious complication. This is because
bacteria that live in digestive system can move into stomach and infect the
lining of abdomen (the peritoneum). This is known as peritonitis.

Peritonitis
• In peritonitis, the infection can rapidly spread into the blood (sepsis)before
spreading to other organs.
• This carries the risk of multiple organ failure. If it isn't treated properly, it may
result in death.
• common symptoms of peritonitis is sudden abdominal pain that gets
progressively worse.
INTESTINAL BLEEDING
 TREATMENT

• Antibiotics are used to treat typhoid fever. These medications kill

the bacteria that cause the infection.

• Typhoid fever is treated with ampicillin,

• Chloramphenicol, or cotrimoxazole (Bactrim®)
• fluoroquinolones (including Cipro® and Levaquin®)
• cephalosporins (including Cefepime®), and azithromycin.

• Supportive therapies, such as fluid or electrolyte replacement,

depending on the severity of the infection.
 PREVENTION

• Access to safe water and adequate sanitation,

• Hygiene among food handlers
• Typhoid vaccination are all effective in preventing typhoid fever.

• Two vaccines have been used for many years to protect people from
typhoid fever
• an injectable vaccine based on the purified antigen for people aged over 2
years
• a live attenuated oral vaccine in capsule formulation for people aged over 5
years
 NURSING MANAGEMENT AND HEALTH EDUCATION
• Wash hands before and after handling something
• Avoid drinking untreated water.

• Choose well-cooked food.

• Avoid raw food and vegetables.

• Avoid eat the food and beverages from the street vendor.
• Remember taking antibiotic injection as doctor’s order.

• Getting vaccinated before travelling to another country

where common gets the typhoid

• Follow up with the doctor

 REFERENCE

• Crump JA, Youssef FG, Luby SP, et al. . Estimating the

incidence of typhoid fever and other febrile illnesses in
developing countries. Emerg Infect Dis 2003; 9:539–44.

• Breiman RF, Cosmas L, Njuguna H, et al. . Population-based

incidence of typhoid fever in an urban informal settlement and
a rural area in Kenya: implications for typhoid vaccine use in
Africa. PLoS One 2012; 7:e29119.