Typhoid fever in children group presentation-


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Done by year 2 Rural Health Students at Divine Word University
Bryan. Pulayasi, Jemina. Hetuka, Yvette. Dunstan, Gabriella. Kinaram, Jubilee. Paru, Francis. Epieli, Natalie. Apaya and Crystal Keiwaga

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Typhoid fever in children group presentation-

  1. 1.  A mother brings her 4 year old child to a physician with the complaints of fever, abdominal pain, vomiting and bloody diarrhea.  On history and examination the child had rose spots on the abdomen and a temperature of 38˚C.  A RDT test tested negative for malaria parasites 2
  2. 2.  Typhoid fever is a systemic infection cause by the bacterium Salmonella typhi or S.enterica  Gram-negative short bacillus  Incubation period 3-56 days  Live in humans and are spread through a person’s feces or urine 3
  3. 3.  Both ill and carriers of the disease can spread the typhoid bacteria through their feces.  Flies are known to help transmit the disease because when they land on human feces, it remain on their appendages and can be transmitted when they land on food or water.  Hand-to-mouth transmission after using a contaminated toilet and neglecting hand hygiene 4
  4. 4.  If the bacteria survive acidity of the stomach, it reaches the small intestine and invades the Payer’s patches.  WBCs carry the disease to the liver, spleen and the bone marrow where it reproduces and re-enters the blood stream  The bacteria then invades the gallbladder, biliary system and the lymphatic tissue of the bowel. 5
  5. 5. 6  Progressive elevation of temperature and bacteremia in the 1st week  Abdominal pain, spleen enlargement and rose spots in 2nd week  Bacteria start causing necrosis of Payer’s patches which leads to perforation and hemorrhage in 3rd week
  6. 6.  Intestinal hemorrhage  Due to bleeding in Payer’s Patches  May bleed from several areas of intestine/massive silent bleeding  Occurs 14-21 days after onset of illness Signs & Symptoms  Hypovolemic shock  Pale conjunctivae  Hematemesis  Bloody stool 7
  7. 7. Intestinal Hemorrhage 8
  8. 8.  Intestinal perforation  One of the most serious complications  Occurs during 3rd week after onset of infection Signs & Symptoms  Fever  Presence of fluid in the abdomen (ascites)  Absent bowel sounds  Vomiting  Tenderness and guarding 9 Complications
  9. 9. Intestinal Perforation 10
  10. 10.  Toxic myocarditis  Meningitis  Encephalitis  Hepatomegaly  Splenomegaly  Kidney failure 11
  11. 11.  Chloramphenicol for at least 2 weeks; 3 weeks if possible  Stat: IMI 6 hourly  Change to oral upon improvement  Alternatives: ampicillin/amoxicillin for 3 weeks/cotrimoxazole for 2 weeks  Anti-malarials  Fluids  Nutrition rehabilitation 12
  12. 12.  Get vaccinated against typhoid fever  There are 2 types of vaccines I. Inactive (killed) vaccine in a shot (Vi capsular polysaccharide vaccine) II. Live, attenuated (weakened) vaccine taken orally (Ty21a) 13
  13. 13.  Avoid risky foods and drinks  Improve sanitation  Access to safe drinking water  Wash hands before handling food  Carriers of typhoid must not be allowed to work as food handlers  Proper waste disposal 14
  14. 14.  S. typhi and S. paratyphi are ingested through contaminated water or food and spreads through poor hygiene habits and public sanitation conditions, and also flying insects feeding on feces  Bacterium multiplies in the gallbladder, bile duct ,or liver and passes into the bowel.  Typical signs are fever(as high as 400 C), diarrhea, headache, abdominal pain and rashes  Treatments include fluids and electrolytes (oral and IV)  If not treated appropriately can lead to complications such as splenomegaly, hepatomegaly, toxic myocarditis and other systematic complications  A careful and proper history must be taken in order to make proper diagnosis 15
  15. 15. 16
  16. 16.  Typhoid fever, (2005). Retrieved, August 6th, 2013, from http://www.cdc.gov/nczred/divisions/dfbmd/diseases/typhoid- fever/  Bacterial defense against phagocytosis. (2013). Retrieved, August 6th , 2013, from http://www.textbookofbacteriology.net/antiphago.html  WHO. (2003). Background document: The diagnosis, treatment & prevention of typhoid fever. Retrieved , August 6th ,2013, from http://www.whqlibdoc.who.int/hq/2003/WHO_V&B_03.07.pdf  Typhoid fever in children. (2012). Retrieved, August 5th , 2013, from http://www.babycenter.in/a1050356/typhoid#ixzz2anyDsNH5 and http://www.babycenter.in/a1050356/typhoid#ixzz2anyNSLKF 17
  17. 17. 18 Remember to wash your hands after using the toilet!!!! Any Questions?