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What is Typhoid Fever ? How to treat it
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| What is Typhoid Fever? How to treat it |
Typhoid Fever is a febrile illness due to infections by a bacteria called association with paratyphoid fever. Both are commonly called Enteric Salmonella Typhi. Typhoid fever usually does not occur alone but in fever. The disease is transmitted by the fecal-oral route. It is associated with education, contamination of drinking water by fecal matter. In recent with poor environmental sanitation, poverty, overcrowding, low level educated people who are also in the high social bracket. Travelers are more at risk.
CLINICAL FEATURES OF ENTERIC FEVER
Most of the time, the patient does not present classically but presents as a case of malaria fever.
1. Fever;
4. Loss of appetite;
2. Headache;
5. Weakness;
3. Joint and body pain; 6. Nausea and or vomiting.
The majority of the patients treat themselves for malaria fever with one or more of the antimalarial drugs. Some usually get relieved following this treatment which most of the time is done in a chemist shop. However, a day or two after the seeming relief, the patient re-presents now in the clinic with:
1. Fever usually with chills and rigors.
2. Severe throbbing headache.
3. Abdominal pain and or fullness.
4. Constipation which may alternate with diarrhea.
5. Vomiting.
6. Dry cough.
If no treatment is given at this point the illness may progress to delirium and death is imminent.
Investigations:-
1 Stool culture.
2 Blood for Widal reaction.
PREVENTION OF ENTERIC FEVERS
1. Good environmental sanitation with emphasis on adequate sewage disposal.
2. Good drinking water.
3. Screening food vendors and food handlers on regular basis.
4. Travellers to be mindful of what they eat.
TREATMENT
There are many drugs available to the clinician for the treatment of typhoid and paratyphoid fever. Of all these, however, the mainstay still remains Chloramphenicol and Septrin.
Other drugs used for the treatment include:
1. Ampicillin
6. Norden.
2. Amoxycillin.
7. Augmentin
3. Ciproxin.
8. Norbactin.
4. Claforan.
9. Perflacin.
5. Rocephin.
A combination of two drugs is usually advised. Supportive drugs include:
1. Intravenous fluid if indicated.
2. Analgesics.
3. Haematinics.
4. Multivitamins.
5. Maxolone and Buscopan injections in cases of vomiting and abdominal pain respectively.
COMPLICATIONS OF ENTERIC FEVER
1. Haemorrhage.
2. Perforation
3. Aplastic anemia is a side effect of prolonged use of chloramphenicol in high doses.
Typical treatment for outpatients:
1m Analgin 5cc stat
IV Chloramphenicol LG b.dx
Tab Septrin I b-d x %
Cap Amoxil 500 mg b.d x4
Tab Pcmt TDS x4
Cap Fallbitone + DIY x7
Add the following if there is abdominal pain and vomiting:
1m Buscopan 20 mg stat
1m metaxalone 10 mg stat
Tab Buscopan i TDS x4
Tab metaxalone + TDS x 54.
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