Introduction, causes, pathophysiology, diagnostic test and treatment of typhoid

1. Dreamz College of Pharmacy
Typhoid
Mrinal
Assistant Professor
Pharmacology

2. Introduction
• Typhoid fever is a bacterial infection that can spread throughout the body,
affecting many organs. Without prompt treatment, it can cause serious
complications and can be fatal.
• It's caused by a bacterium called Salmonella typhi, which is related to the
bacteria that cause salmonella Food poisoning.
• Typhoid fever is highly contagious. An infected person can pass the
bacteria out of their body in their stools (faeces) or, less commonly, in their
urine.
• If someone else eats food or drinks water that's been contaminated with a
small amount of infected faeces or urine, they can become infected with the
bacteria and develop typhoid fever.
• Children are more susceptible to typhoid, this may be because their
immune system (the body's natural defence against infection and illness) is
still developing. However, children with typhoid fever tend to have milder
symptoms than adults.
• India, Pakistan, and Egypt are also known as high-risk areas for developing
this disease. Worldwide, typhoid fever affects more than 21 million people
annually, with about 200,000 people dying from the disease.

3. Signs and Symptoms
• Symptoms normally begin between 6 and 30 days after exposure
to the bacteria.
• The two major symptoms of typhoid are fever and rash. Typhoid
fever is particularly high, gradually increasing over several days
up to 104 degrees Fahrenheit, or 39 to 40 degrees Celsius.
• The rash, which does not affect every patient, consists of rose-
colored spots, particularly on the neck and abdomen.
• Other symptoms can include: weakness, abdominal pain,
constipation, headaches
• Rarely, symptoms might include confusion, diarrhea, and
vomiting, but this is not normally severe.
• Another infection, paratyphoid, is caused by Salmonella enterica.
It has similar symptoms to typhoid, but it is less likely to be fatal.

5. How we diagnose Typhoid
• Diagnosis is made by any blood, bone marrow
or stool culture and with the widal test
(Demonstration of salmonella antibodies
against antigens O-somatic and H-flagellar).
• Testing for H agglutinins in Dryers tubes , a
narrow tube floccules at the bottom
• Testing for O agglutinins in Felix tubes,
Chalky
• Incubated at 37 degree celsius overnight.

6. Why we still use Widal test
The Widal test is an old
serologic assay for detecting
IgM and IgG to the O and H
antigens of salmonella. The
test is unreliable but is
widely used in most
developing countries
because of its low cost.

7. Treatment
• The only effective treatment for typhoid
is antibiotics. The most commonly used
are ciprofloxacin (for non-pregnant
adults) and ceftriaxone.
• Other than antibiotics, it is important to
rehydrate by drinking adequate water.
• In more severe cases, where the bowel
has become perforated, surgery may be
required.