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Typhoid fever
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Typhoid
fever is an infection (caused by bacteria) that is spread through contaminated food. The bacteria enter the host through the intestinal tract, and migrate to other parts of the body through the bloodstream. Prevention is the best strategy. However, if infection does occur, antibiotics will be needed.
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- Symptoms usually begin with a headache, sore throat, cough, fatigue, abdominal pain, and Constipation.
Also, the infected party will usually have a low-grade
fever.
- Within about 7 to 10 days, the patient becomes much more ill with increasing fever, extreme exhaustion, severe Constipation or "pea soup" Diarrhea, and
distended abdomen.
- Usually, the patient will get better
over the next 7-10 days.
- When examined, enlarged spleen, distended abdomen, Slow Heart Rate, and
neck stiffness may be detected. Also, there may be a
rash (described as "rose spots") that appears during the
second week of the illness. This rash may last for a
few days.
- Some people may become extremely ill. Severe complications may develop, including Shock, intestinal bleeding, holes in the intestine, Pneumonia, or psychotic behavior. Infections of the heart, kidneys, gallbladder, bones, or brain are additional possible complications.
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- The cause of the disease is a bacterium known as Salmonella enterica serotype typhi. Once it enters the host, it spreads via the bloodstream and begins to multiply in different parts of the body, including the lungs, kidneys, gallbladder, and brain.
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- Diagnosis is made by Blood culture tests
that detect the bacteria. Stool culture tests are not
as useful.
- If all the Blood cultures are normal, a sample of bone marrow may be sent for testing.
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- Once one contracts the infection, he will need to be
treated with antibiotics, given intravenously or by mouth,
depending on the severity of the illness.
- The antibiotic most often used is
trimethoprim-sulfamethoxazole. Other antibiotics that
may be used are ceftriaxone and ciprofloxacin (but this
should not be used in children and pregnant women).
Ampicillin and chloramphenicol may also be used, but they
are often not effective.
- Treatment needs to be continued for 2 weeks.
- Up to 2% of people who develop typhoid fever die.
Older patients and those with other medical conditions have
a higher risk of death. Children usually do fine with
treatment.
- Repeat infections occur in up to 15% of those treated.
- People who develop complications have a much higher risk of dying.
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- Prevention of the infection is the main key to
controlling this disease. Vaccines are available, but
they are not always successful. People in contact with
infected individuals, and those who are travelling to areas
where the infection is common, should be immunized.
Also, if there is an epidemic, vaccinations should be
given.
- Vaccines can be administered by injection or taken by
mouth. The oral vaccine has fewer side effects.
Booster doses are needed 5 years after the oral vaccine, and
3 years after the injected vaccine.
- Anyone who is infected should not be allowed to work
around food.
- Also, good hygiene is essential in preventing the infection.
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- Some people carry the bacteria but
do not become sick. They can, however, spread the
infection to others. They are known as carriers, and
they definitely should not be allowed to prepare or handle
food.
- These people need to be treated
with antibiotics to remove the bacteria from the
body. 750 milligrams of ciprofloxacin taken twice a
day for four weeks is most often (but not always)
effective.
- Also, in some, removal of the gallbladder has proven to be necessary and effective in eliminating the bacteria.
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