bams-4th-year-typhoid-enteric-fever-29-04-2020.pptx
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Dr. Namrata Modi discusses typhoid fever in the Department of Kayachikitsa at HAMC Dehradun. She summarizes that typhoid bacilli reach the small intestine, penetrate the mucosa, enter the lymphatics via Peyer's patches, and disseminate throughout the body. Symptoms can include general toxaemia, gastrointestinal perforation or hemorrhage, neurological issues like delirium or meningitis, and other complications. Diagnosis involves blood, stool, or urine cultures during different stages of illness as well as the Widal test or other serological tests. Treatment of chronic carriers may include ciprofloxacin for 4 weeks or cholecystectomy in
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- 7. an-
- 11. Typhoid Bacilli Reach to small intestine Penetrate mucosa Enters intestinal lymphatics( via peyer’s patches) Blood stream Disseminated throuhout body( intracellular multipication takes palce) Re-inters bloodstream bacteraemia
- 17. General- Toxaemia,DIC, Shock GIT- Perforation of intestine, Intestinal haemorrhage( 3rd or 4th week of illness) Neurological – Delirium, Psychosis, Coma, Meningitis, Encephalopathy,peripheral neuritis, Deafness Miscellaneous- Myocarditis,Endocarditis,Pericarditis,Glomerulonephritis,Osteomylitis ,Pneumonia, Hepatitis
- 21. CBC – Leucopenia with relative lymphocytosis. Blood culture- During 1st week of illness Stool culture – During 3rd week Urine culture – During 4th week
- 22. Widal test – Detects agglutinating antibodies to O, H and Vi antigens of S. paratyphi A , and B, other Salmonella species. Antibodies against the O antigen are predominating IgM, rise early in the illness and disappear early. In the absence of recent immunisation, a high titre of O antibodies (= 1:320) is useful, but not specific for typhoid. The H antigen are flagellar antigens of Salmonella typhi, paratyphi A and B. Antibodies to H antigens are both IgM and IgG, rise late in the illness and persist for longer time. Other Serological tests: Typhi dot- detects IgM and IgG antibodies ( against a outer membrane protein) Molecular methods – PCR to detect flagellin, sometic gene, Vi gene.
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