TYPHOİD FEVER

TYPHOİD FEVER

TYPHOİD FEVER

TYPHOID FEVER IS CAUSED BY SALMONELLA TYPHI BACTERIA. TYPHOID FEVER IS RARE IN INDUSTRIALIZED COUNTRIES. HOWEVER, IT REMAINS A SERIOUS HEALTH THREAT IN THE DEVELOPING WORLD, ESPECIALLY FOR CHILDREN.

TYPHOID FEVER SPREADS THROUGH CONTAMINATED FOOD AND WATER OR THROUGH CLOSE CONTACT WITH SOMEONE WHO’S INFECTED. SIGNS AND SYMPTOMS USUALLY INCLUDE HIGH FEVER, HEADACHE, ABDOMINAL PAIN, AND EITHER CONSTIPATION OR DIARRHEA.

MOST PEOPLE WITH TYPHOID FEVER FEEL BETTER WITHIN A FEW DAYS OF STARTING ANTIBIOTIC TREATMENT, ALTHOUGH A SMALL NUMBER OF THEM MAY DIE OF COMPLICATIONS. VACCINES AGAINST TYPHOID FEVER ARE AVAILABLE, BUT THEY’RE ONLY PARTIALLY EFFECTIVE. VACCINES USUALLY ARE RESERVED FOR THOSE WHO MAY BE EXPOSED TO THE DISEASE OR ARE TRAVELING TO AREAS WHERE TYPHOID FEVER IS COMMON.

SYMPTOMS

SIGNS AND SYMPTOMS ARE LIKELY TO DEVELOP GRADUALLY — OFTEN APPEARING ONE TO THREE WEEKS AFTER EXPOSURE TO THE DISEASE.

EARLY ILLNESS

ONCE SIGNS AND SYMPTOMS DO APPEAR, YOU’RE LIKELY TO EXPERIENCE:

  • 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
  • DIARRHEA OR CONSTIPATION
  • RASH
  • EXTREMELY SWOLLEN ABDOMEN

LATER ILLNESS

IF YOU DON’T RECEIVE TREATMENT, YOU MAY:

  • BECOME DELIRIOUS
  • LIE MOTIONLESS AND EXHAUSTED WITH YOUR EYES HALF-CLOSED IN WHAT’S KNOWN AS THE TYPHOID STATE

IN ADDITION, LIFE-THREATENING COMPLICATIONS OFTEN DEVELOP AT THIS TIME.

CAUSES

FECAL-ORAL TRANSMISSION ROUTE

THE BACTERIA THAT CAUSE TYPHOID FEVER SPREAD THROUGH CONTAMINATED FOOD OR WATER AND OCCASIONALLY THROUGH DIRECT CONTACT WITH SOMEONE WHO IS INFECTED. IN DEVELOPING NATIONS, WHERE TYPHOID FEVER IS ENDEMIC, MOST CASES RESULT FROM CONTAMINATED DRINKING WATER AND POOR SANITATION. THE MAJORITY OF PEOPLE IN INDUSTRIALIZED COUNTRIES PICK UP TYPHOID BACTERIA WHILE TRAVELING AND SPREAD IT TO OTHERS THROUGH THE FECAL-ORAL ROUTE. THIS MEANS THAT S. TYPHI IS PASSED IN THE FECES AND SOMETIMES IN THE URINE OF INFECTED PEOPLE

TYPHOID CARRIERS

EVEN AFTER TREATMENT WITH ANTIBIOTICS, A SMALL NUMBER OF PEOPLE WHO RECOVER FROM TYPHOID FEVER CONTINUE TO HARBOR THE BACTERIA IN THEIR INTESTINAL TRACTS OR GALLBLADDERS, OFTEN FOR YEARS. THESE PEOPLE, CALLED CHRONIC CARRIERS, SHED THE BACTERIA IN THEIR FECES AND ARE CAPABLE OF INFECTING OTHERS, ALTHOUGH THEY NO LONGER HAVE SIGNS OR SYMPTOMS OF THE DISEASE THEMSELVES.

COMPLİCATİONS

INTESTINAL BLEEDING OR HOLES

THE MOST SERIOUS COMPLICATIONS OF TYPHOID FEVER — INTESTINAL BLEEDING OR HOLES (PERFORATIONS) IN THE INTESTINE — MAY DEVELOP IN THE THIRD WEEK OF ILLNESS. A PERFORATED INTESTINE OCCURS WHEN YOUR SMALL INTESTINE OR LARGE BOWEL DEVELOPS A HOLE, CAUSING INTESTINAL CONTENTS TO LEAK INTO YOUR ABDOMINAL CAVITY AND TRIGGERING SIGNS AND SYMPTOMS, SUCH AS SEVERE ABDOMINAL PAIN, NAUSEA, VOMITING AND BLOODSTREAM INFECTION (SEPSIS). THIS LIFE-THREATENING COMPLICATION REQUIRES IMMEDIATE MEDICAL CARE.

OTHER, LESS COMMON COMPLICATIONS  

  • MYOCARDITIS
  • ENDOCARDITIS
  • PNEUMONIA
  • PANCREATITIS
  • KIDNEY OR BLADDER INFECTIONS
  • MENINGITIS

DİAGNOSİS

YOUR DOCTOR IS LIKELY TO SUSPECT TYPHOID FEVER BASED ON YOUR SYMPTOMS AND YOUR MEDICAL AND TRAVEL HISTORY. BUT THE DIAGNOSIS IS USUALLY CONFIRMED BY IDENTIFYING S. TYPHI IN A CULTURE OF YOUR BLOOD OR OTHER BODY FLUID OR TISSUE. FOR THE CULTURE, A SMALL SAMPLE OF YOUR BLOOD, STOOL, URINE OR BONE MARROW IS PLACED ON A SPECIAL MEDIUM THAT ENCOURAGES THE GROWTH OF BACTERIA. THE CULTURE IS CHECKED UNDER A MICROSCOPE FOR THE PRESENCE OF TYPHOID BACTERIA. A BONE MARROW CULTURE OFTEN IS THE MOST SENSITIVE TEST FOR S. TYPHI.

TREATMENT

CIPROFLOXACIN (CIPRO). CEFTRIAXONE (ROCEPHIN). – COMMONLY PRESCRIBED ANTIBIOTICS

  • DRINKING FLUIDS
  • SURGERY – IF YOUR INTESTINES BECOME PERFORATED.

IN MANY DEVELOPING NATIONS, THE PUBLIC HEALTH GOALS THAT CAN HELP PREVENT AND CONTROL TYPHOID FEVER — SAFE DRINKING WATER, IMPROVED SANITATION AND ADEQUATE MEDICAL CARE — MAY BE DIFFICULT TO ACHIEVE. FOR THAT REASON, SOME EXPERTS BELIEVE THAT VACCINATING HIGH-RISK POPULATIONS IS THE BEST WAY TO CONTROL TYPHOID FEVER.

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