Enteric fever in pediatrics
•Download as PPTX, PDF•
10 likes•8,663 views
introduction,ciniical features,incidence, and management
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Enteric fever in pediatrics
Similar to Enteric fever in pediatrics (20)
More from Shambhavi Sharma
More from Shambhavi Sharma (20)
Recently uploaded
Recently uploaded (20)
Enteric fever in pediatrics
- 2. Introduction • Also known as “typhoid fever” • Etiology: ▫ Salmonella enterica typhi ▫ Salmonella paratyphi A,B,C • typhi: paratyphi = 10:1 • Route of transmission: faecal-oral route • Incubation period: 7- 14 days
- 3. Pathogenesis Oro-faecal route M cells of gut mucosa of terminal ileum Peyer’s patch Mesenteric lymph node Primary bacteremia Reticulo-endothelial system Secondary bacteremia Disseminated to different organs
- 4. Clinical features • High grade fever • Coated tongue • Anorexia • Vomiting • Diarrhoea/ constipation • Abdominal pain • Headache • Obtundation
- 5. Examination • Relative bradycardia • Rose spots on trunk ( 1st week) • Hepatosplenomegaly • Tympanic abdomen
- 6. Complications • CNS ▫ Encephalopathy, delirium, ataxia, seizure • CVS ▫ Endocarditis, myocarditis, CCF • Respiratory ▫ Pneumonia, empyema • Gastrointestinal ▫ Peritonitis, paralytic ileus. Perforation
- 7. • Hepatobiliary ▫ Cholecystitis, heptitis, hepatic or splenic abscess • Genitourinary ▫ UTI, renal abscess, prostatitis • Bones ▫ Osteomyelitis, septic arthritis
- 8. Investigations • Leukopenia with relative lymphocytosis • Deranged LFT • Blood culture • Agglutination test ▫ Widal test, Typhidot • Stool culture • Urine culture • Bone marrow culture • Monoclonal Antibody • PCR
- 9. Differential diagnosis • Viral fever • Malaria • Tuberculosis • Septicemia • Brucellosis • Leptospirosis • Dengue • Infectious mononucleosis • Acute hepatitis
- 10. Treatment • Adequate rest • Hydration • Antipyretics • Soft diet • Antibiotic treatment • Encephalopathy/ Shock: ▫ Dexamethasone ▫ 3mg/kg stat and 1mg/kg QID 48 hrs
- 11. Antibiotic treatment • Uncomplicated typhoid: ▫ Chloramphenicol : 50-75 mg/kg/d QID 14-21d ▫ Amoxycillin : 75 mg/kg/d TID 14 d ▫ Fluroquinolones: 15mg/kg/d BD 7-10 d ▫ Cefixime: 15- 20 mg/kg/d BD 7-14 d ▫ Azithromycin : 8-10 mg/kg/d OD 7d • Severe typhoid: ▫ Ampicillin: 100mg/kg/d IV QID 14 days ▫ Ceftriaxone: 60-75mg/kg/d BD 10-14days ▫ Gatifloxin: 10 mg’kg/d 7 days
- 12. Prognosis • Age • General state of the health • Chronic carriers: ▫ Gall bladder ▫ Excretes S. typhi for >3mnths
- 13. Prevention • Proper sewage/ sanitation • Hand washing • Vaccination ▫ Oral live vaccine: Ty21a strain ▫ Vi capsular polysaccharide vaccine
- 14. Thank you