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2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14
Typhoid fever has been known as a disease since the days of Hippocrates. It was he who introduced this definition in medical practice. This disease belongs to a number of intestinal infections and is a rather dangerous problem, primarily fraught with complications, which can be eliminated only with the involvement of surgery.
In general, typhoid fever is an acute generalized infection in the intestinal region, characteristic only of humans and associated with damage to the lymphatic system of the small intestine, lymph nodes of the large folding process of the peritoneum.
Description of the problem: what constitutes typhoid fever
Describing the pathogenesis, experts often associate it with the main stages of development of typhoid fever in children and adults.
- Incubation stage. During this period, direct infection occurs by swallowing, during which some of the pathogenic microorganisms die, unable to withstand the aggressive acidic environment of the stomach, and the strongest penetrate into the region of the small intestine, the alkaline environment of which is most favorable for them. Further, the infection enters the intestinal lymph formation, where it multiplies, forming foci with granulomatosis. From the original focus, the infection spreads to the local lymph nodes. Due to the incomplete process of capture and absorption of bacteria by phagocytes, they penetrate the bloodstream, provoking the development of endotoxinemia. The consequence is the spread, in addition to the intestines, in other organs and systems;
- The peak of the disease. It is associated with the return of bacteria back into the bloodstream and the secretion of the bacillus in feces, saliva, urine, or breast milk;
- Reconvalescence. During the period of restoration of normal vital activity of the organism after an illness, the intensity of specific humoral immunity increases. However, the pathogen can persist in macrophages and contribute to the development of bacterial carriers.
Possible causes of typhoid fever
Despite the fact that the concept was discovered a long time ago, medicine for a long time could not establish the specific causes of this disease. Until the exact pathogen was identified, typhus was considered all diseases, the main symptom of which was a pronounced fever.
Since the nineteenth century, the pathogen has become known. This is salmonella typhi from the Enterobacteriacea family. Its more common name is typhoid stick. The discovery was facilitated by such studies as microscopy of sections of the spleen, lymph nodes of the large folding process of the peritoneum, carried out in the seventies of the nineteenth century by a scientist from Poland Bronich. A detailed description was given already in the eighties by K. Ebert, and the culture itself was revealed four years later by G. Gaffki.
One of the main features of the stick is its anthroponosity. In addition, unlike organisms similar to it, it is more mobile, since it has a large number of flagella, is not capsule or spore-forming and does not stain according to Gram.
Salmonella typhi is a lively one. The incubation period in an aquatic environment, in a layer of ice or soil is several months, and they can die only when boiling.
The main source in children and adults is a sick, convalescent or bacterial carrier. The pathogenic microorganism is excreted along with the feces of the above representatives and infects objects, food and water that have come into contact with the environment into which the waste was thrown. The mechanism of infection is called fecal-oral.
The most popular season for the activation of bacteria is summer-autumn, however, accidental infection associated with bacterial secretions from bacteria carriers is also possible.
Both adults and children are at risk of infection. The immunity of a person who has had typhoid fever becomes very persistent and lasts all his life.
Overview of Key Symptoms of Typhoid Fever
The clinical picture implies a number of symptoms characteristic of this disease, both in children and in adults:
- Malaise and weakness of the body, increasing gradually;
- A gradual rise in temperature, developing into a fever;
- Signs of intoxication, which may manifest as weakness, complete loss of appetite or insomnia;
- Dehydration of the body, which can be externally determined by the skin, tongue, on which the marks of teeth are imprinted, constant thirst;
- Unstable stools when diarrhea follows constipation.
The temperature "under forty" lasts about two weeks, while symptoms of typhoid status such as lethargy, poor sleep, periodic hallucinations, tremors in the limbs begin to appear.
A doctor who will examine an adult or child will be able to determine the presence of an abdominal type and take urgent measures for the following signs in children and adults:
- Typical fever described above;
- Typhoid rash of a rounded shape with clear outlines, but a dull color, arising in front of the abdominal wall and / or on the sides of the chest;
- Enlargement of organs such as the liver and spleen;
- Pain and bloating in the abdomen;
- An increase in the size of the lymph nodes in the abdominal region;
- Changes in the area of the nervous system, which is called typhoid status.
Diagnosis of typhoid fever
In both children and adults, it includes three components:
- Analysis of the anamnesis, that is, direct contact with the patient;
- Collection from the patient and during the examination of the characteristic symptoms;
- Laboratory tests, including blood sampling and culture, urinalysis and stool analysis, and in some cases examination of contents from the duodenum, which are the areas where bacteria survive the longest.
How to Get Rid of - Typhoid Fever Treatment
In no case should the treatment of typhoid fever in children and adults be carried out at home. At the first symptoms, it is necessary to contact the clinic, where the patient will be prescribed bed rest for a duration equal to the entire period of fever, plus another week after the temperature returns to normal.
Discharge of the patient is possible only after bringing the body temperature back to normal, plus at least three more weeks. In this case, the results of sowing stool three times in a row should give negative results. Also, a one-time bacterial test of bile is mandatory.
Review of several pharmaceutical preparations
Etiotropic therapy involves taking drugs against bacteria, which are aminoglycosides and fluoroquinolones. They can be assigned both individually and as a complex.
The fight against the root cause, that is, detoxification, is carried out by introducing into the blood such medicinal substances as enterosorbents (binding and removing pathogenic microflora from the body), glucose, hemodez (sterile water-saline solution), rheopolyglucin (anti-shock drug). In parallel, you need to drink plenty of fluids.
Symptomatic therapy includes vitamin therapy, taking sleeping pills, sedative medicines (herbs), and antipyretics.
If bleeding develops during the spread of the disease, then hemostatic therapy is also added to the above measures.
If intestinal perforation occurs, surgical intervention is indispensable.
Prevention of further development of the disease
Only through the prevention of typhoid fever among children and adults can its spread be resisted.
The measures for this are quite simple, but following them can save you from many serious health problems:
- Strict observance of elementary sanitary rules regarding the supply of dwellings with water and its control, rules for the transportation and sale of food, informing the population about the dangers of non-observance of hygiene;
- Monitoring the health of certain groups of the population, such as: employees of medical institutions, food enterprises, water stations and similar organizations. Mandatory conditions for hiring in this case should be a medical book with information on feces and blood tests;
- Registration of patients - children and adults, discharged from a medical institution after treatment for typhoid fever - on the account, implying regular examinations;
- If there was contact with an infected person, and you know about it, it is necessary to be tested within twenty one days.
Typhoid fever in both children and adults is difficult to cure.
Despite the fact that with the development of medicine and the improvement of the general quality of life in our time, the risk of infection is much lower, it still takes place, so it is important to stay alert and be attentive to any changes in your body and prevent complications.