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TYPHOID DISEASE
BY:- MANSI PANCHAL
SWAMINARAYAN UNIVERSITY
PHARMD
WHAT IS TYPHOID FEVER?
 An acute illness with fever caused by infection with the Salmonella typhi contracted by
contaminated food.
 It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a
less severe illness.
 Also called enteric fever, bilious fever and yellow fever.
 About 16 million cases of typhoid fever and 600,000 deaths occur yearly worldwide
and that more than 90% of this morbidity and mortality occurred in Asia.
 The term “ENTERIC FEVER” includes both typhoid and paratyphoid fevers.
TYPHOID BACILLI
BACTERIOLOGY-
TYPHOID FEVER
• The Genus Salmonella belongs
to Family Enterobactericeae.
• Facultative anaerobe.
• Gram Negative Bacilli.
• Best grown at 37 C.
• Distinguished from other
bacteria by biochemical and
antigen structure.
ETIOLOGY
1. BACTERIA :- Virulent bacteria that causes illness called Salmonella Typhi.
2. FECAL-ORAL ROUTE:- spread through contaminated food or water and
occasionally through direct contact with someone who is infected.
3. TYPHOID CARRIERS:- These people, called chronic carriers, shed the
bacteria in their faeces and are capable of infecting others.
• INCUBATION PERIOD:- onset of symptoms – 5 to 21 days.
CLINICAL MANIFESTATION
• Poor appetite
• Headache
• Generalized pain and aches
• Diarrhea
• Nausea and vomiting
• Fever (103-104 F or 39-40 C)
• Lethargy
• Chest congestion
• Slow heartbeat
• Constipation
• Rose spots
• Typhoid meningitis
• Rash
• Weakness and fatigue
• Weight loss
• Intestinal bleeding
Symptoms
PATHOPHYSIOLOGY
S.typhi contracted from contaminated food and water.
Ingested by human. The S.typhi survives the acidity of the stomach.
It invades the peyer’s patches of the intestinal wall.
The bacteria is within the macrophages and survives.
Bacteria spreads via the lymphatics while inside the macrophages.
PATHOPHYSIOLOGY CONTINUED…
Access to reticuloendothelial system, liver, spleen, gall bladder and bone
marrow.
1st week : Elevation of the body temperature.
2nd week : Abdominal pain, Spleen enlargement and rose spots.
3rd week : necrosis of the Peyer’s patches
Leads to perforation, bleeding, and if left untreated, death is imminent.
DIAGNOSIS
• Blood culture
• Complete blood count (CBC)
• Widal test
• Elisa test
• Urine and stool culture
• Punch-biopsy samples of rose spots culture
TREATMENT
• Activity – rest is helpful.
• Medical care – antibiotics (ampicillin, azithromycin, ciprofloxacin,
ceftriaxone) for 14 days.
-corticosteroids
-antipyretics
• Diet – Soft digestible diet with lots of fluid and electrolytes.
• Surgical care – in case of intestinal perforation.
• VACCINES : TAB vaccine , Live oral vaccine, Vi vaccine
• COMPLICATIONS : GI bleeding, GI perforation, myocarditis
• PREVENTION : wash hands, drink boiled water, clean fruits and
vegetables , get vaccinated.

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Typhoid fever or enteric fever

  • 1. TYPHOID DISEASE BY:- MANSI PANCHAL SWAMINARAYAN UNIVERSITY PHARMD
  • 2. WHAT IS TYPHOID FEVER?  An acute illness with fever caused by infection with the Salmonella typhi contracted by contaminated food.  It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness.  Also called enteric fever, bilious fever and yellow fever.  About 16 million cases of typhoid fever and 600,000 deaths occur yearly worldwide and that more than 90% of this morbidity and mortality occurred in Asia.  The term “ENTERIC FEVER” includes both typhoid and paratyphoid fevers.
  • 4. BACTERIOLOGY- TYPHOID FEVER • The Genus Salmonella belongs to Family Enterobactericeae. • Facultative anaerobe. • Gram Negative Bacilli. • Best grown at 37 C. • Distinguished from other bacteria by biochemical and antigen structure.
  • 5. ETIOLOGY 1. BACTERIA :- Virulent bacteria that causes illness called Salmonella Typhi. 2. FECAL-ORAL ROUTE:- spread through contaminated food or water and occasionally through direct contact with someone who is infected. 3. TYPHOID CARRIERS:- These people, called chronic carriers, shed the bacteria in their faeces and are capable of infecting others. • INCUBATION PERIOD:- onset of symptoms – 5 to 21 days.
  • 6. CLINICAL MANIFESTATION • Poor appetite • Headache • Generalized pain and aches • Diarrhea • Nausea and vomiting • Fever (103-104 F or 39-40 C) • Lethargy • Chest congestion • Slow heartbeat • Constipation • Rose spots • Typhoid meningitis • Rash • Weakness and fatigue • Weight loss • Intestinal bleeding
  • 8. PATHOPHYSIOLOGY S.typhi contracted from contaminated food and water. Ingested by human. The S.typhi survives the acidity of the stomach. It invades the peyer’s patches of the intestinal wall. The bacteria is within the macrophages and survives. Bacteria spreads via the lymphatics while inside the macrophages.
  • 9. PATHOPHYSIOLOGY CONTINUED… Access to reticuloendothelial system, liver, spleen, gall bladder and bone marrow. 1st week : Elevation of the body temperature. 2nd week : Abdominal pain, Spleen enlargement and rose spots. 3rd week : necrosis of the Peyer’s patches Leads to perforation, bleeding, and if left untreated, death is imminent.
  • 10. DIAGNOSIS • Blood culture • Complete blood count (CBC) • Widal test • Elisa test • Urine and stool culture • Punch-biopsy samples of rose spots culture
  • 11. TREATMENT • Activity – rest is helpful. • Medical care – antibiotics (ampicillin, azithromycin, ciprofloxacin, ceftriaxone) for 14 days. -corticosteroids -antipyretics • Diet – Soft digestible diet with lots of fluid and electrolytes. • Surgical care – in case of intestinal perforation.
  • 12. • VACCINES : TAB vaccine , Live oral vaccine, Vi vaccine • COMPLICATIONS : GI bleeding, GI perforation, myocarditis • PREVENTION : wash hands, drink boiled water, clean fruits and vegetables , get vaccinated.