- 1 INTRODUCTION
- 1.1 TYPHOID FEVER
- 1.2 DEFINITION
- 1.3 TYPES
- 1.4 EPIDEMIOLOGY-:
- 1.5 CAUSES OF TYPHOID (ETIOLOGY)
- 1.6 PATHOPHYSIOLOGY
- 1.7 SYMPTOMS OF TYPHOID (CLINICAL MANIFESTATION)
- 1.8 DIAGNOSIS EVALUATION
- 1.9 NURSING MANAGEMENT
- 1.10 TREATMENT AND MEDICATION
- 1.11 TYPHOID VACCINES
- 1.12 COMPLICATIONS
- 1.13 HEALTH CARE
- 1.14 PREVENTION
Typhoid fever is a bacterial disease transmitted by food or water coacervated with the bacteria Salmonella typhi. This disease is a water bourn and air bourn disease etc. water bourn disease way is like -diarrhea cholera typhoid. it can cause abdominal pain headache and loss of appetite.
“Typhoid fever “also called enteric fever. typhoid fever is an infection of the intestinal tract and occasionally the bloodstream. the germ that causes typhoid is a unique human strain of salmonella called Salmonella typhi. typhoid fever is mainly transmitted by ingestion.
The illness is characterized by prolonging typical continuous fever 3-4 weeks bradycardia and involvement of spleen and lymph nodes.
“Typhoid fever is an acute infectious disease caused by Salmonella typhi”.
“A typhoid fever is an enteric fever is an infection causes the bacterial Salmonella typhi“.
“Typhoid is a usually curable but sources bacterial in are essentially resistance to antibiotic”.
“The Typhoid is an infectious disease of the small intestine which is characterized by prolongest fever toxic symptoms or constitutional disturbance”.:
” A Typhoid fever is a bacterial disease transmitted by food or water with the bacteria Salmonella typhi”.
Typhoid fever are two types
- Typhoid fever-Its cause by Gram-Negative organism salmonella enterica subspecies enterica serovar Typhi (Salmonella typhi)
- Paratyphoid fever-Paratyphoid fever is caused by three serovars of Salmonella enterica subspecies enterica its is a three types
- Schottmuelleri-B (also called S.paratyphi B)
- Hirschfeldii-C (Also called S.paratyphi C)
- The causative organism of typhoid fever is s.typhi.
- The agent is being carried by cases and carrier in their stool or urine.
- Sources of infection are primary sources are urine and feces of case and carrier and secondary sources are contaminated water, food, finger flies etc.
- The Typhoid fever is having the highest incidence in 5-19yr of age group but it can occur at any age.
- It occurs more in males and females but in female carriers rate is more.
- Typhoid fever occurs throughout the year but peak incidence is during July-September rainy seasons.
- Contaminated water food.
- Open defecation and urination.
- Poor personal and environmental hygiene.
Mode of transmission-:
- Direct-By soiled hand contaminated with feces or urine of a case or carrier.
- Indirect-By contaminated water food milk.
- Incubation period-The incubation period is usually 10-14 days but it can range from 3days to 3 weeks.
CAUSES OF TYPHOID (ETIOLOGY)
The following are several ways to causes of typhoid fever
(1).Salmonella Typhi Bacilli-: Typhoid fever is caused by a bacterium salmonella. These bacteria adhere to ileal tissue in the GI tract survive in macrophages cell are the carrier to mesenteric lymph nodes.
(2).By Carrier-: This means the salmonella typhi bacteria continuous live in the carrier body and can be spread as normal in feces or urine but the carrier does have any noticeable symptoms of the condition.
(3).Environment factor-The main factor in causing a typhoid fever is a contaminated food, water, and milk. The following several Environment factor ways we can get typhoid fever
- Drinking contaminated water, drinks and milk.
- Eating fresh fruits that have been washed with contaminated water.
- Direct Contact with someone who is infected with typhoid.
(4).Unhealthy habits-This is caused due to lack of personal hygiene .the following several unhealthy habits can cause typhoid fever
- From eating food without washing your hands.
- Cooking a food without washing vegetables. Its unhealthy habits.
- From touching your mouth after going to the bathroom.
Ingestion of water or food contaminated by Salmonella typhi
S. Typhi are able to survive in the gastric acid of the stomach
In the ileum, s.typhi penetrate mucus and or phagocytes in payer and patella
S. Typhi reach mesenteric lymph nodes and multiply
S. Typhi is carried through the lymphatic system and bloodstream
S.Tphi colonize reticuloendothelial tissue (liver, spleen)
S. Typhi multiply in the gallbladder
S. Typhi is discharged into the intestine
It involves payers patella of the small intestine
SYMPTOMS OF TYPHOID (CLINICAL MANIFESTATION)
The sign and symptom generally visualize 6-30 day after to expose of Salmonella Typhi bacteria.
The child usually presents with a rapid rise of temperature, extreme malaise, loss of appetite, Constipation, abdominal pain, distension.
- Fever– Fever Started at a low level and they increase daily and they fever reach 104 fr.
- Rash-Typhoid rash as a muscular red rose spot may appear on about the 6th day of illness.rash may be visible on the trunk.
- Bradycardia-Bradycardia is a pulse rate is the less than 60 that shows the symptoms of typhoid fever.
- Diarrhea-Diarrhea is usually found than constipation it is the fluid and electrolyte imbalance.
- Abdominal Pain And Distention –Abdomen feels roughly spleen is palpable one or two cm. below coastal margins and liver may also be palpable.
- Headache-Headache is the most common symptoms of typhoid fever, it can be sing stress and emotional distress.
- Loss of appetite
- History Taking-Ask the patient previous history of related to typhoid fever. like what you ate? what you drank? and what is the condition of your environment? how to do you manage your hygiene? etc.
- Physical Examination
- Complete blood count (CBC)-This is the best method to diagnose typhoid fever. If suffering from the disease complete blood count will show an increase of Bacteria in white blood cell (WBC).
- ELISA-A recent diagnostic test ELISA (Enzyme-linked immunosorbent assay) urine test is done to look out for the bacteria causes the disease.
- Widal test-The Widal test is one of the best methods to diagnose typhoid fever. widal test is an agglutination test which detects the presence of serum agglutinins in patient serum with typhoid and paratyphoid fever.
- Platelet Count-Platelet count in the case of the person affected by the disease is usually low.
- Stool Culture-It is done to determine the personality of the bacterium in the feces.
- Bone marrow biopsy-A bone marrow biopsy gives more accurate result us compare to other tests. but it’s far more complex to carried out. a bone marrow biopsy includes needle inserted right into a bone normally the pelvic breastbone to obtain a tissue sample that’s tested underneath a microscope for proof the infection
Identification of the disease by culture blood and stool examination.
- Improve the environment sanitation protection and purification of drinking water.
- Proper control of carriers practically as to sanitation disposal.
- Acute pain related to typhoid fever as manifested by poor facial expression.
- Anxiety related to typhoid fever as evidence by verbalization.
- Fluid and electrolyte imbalance related to typhoid fever as manifested by loss of appetite.
- Hyperthermia related to typhoid fever as evidence by warm body temperature.
- Knowledge deficiency related to typhoid fever as manifested by questioning and answering.
TREATMENT AND MEDICATION
The Analgesic-Antipyretic and Antibiotic Drug is used for the treatment of typhoid.
Antipyretic-This drug decreases the Temperature of the body. Ex-Paracetamol
Antibiotic- Antibiotic drug kills the typhoid fever bacteria. Ex-Ofloxacin, Ciprofloxacin, Ceftriaxone, Chloramphenicol, Co-trimoxazole.
- Ofloxacin-Its inhibit the replication of the DNA of bacteria.
- Ciprofloxacin-Its inhibit the replication of the DNA of bacteria.
- Ceftriaxone-This drug kills the cell wall of the bacteria.
- Cefixime-Inhibit the bacteria cell wall synthesis.
Typhoid vaccines are available.there are two vaccines to prevent typhoid one is inactivated given as a shot. and second is live weekend vaccines which are taken orally.
- Inactivated typhoid vaccine (shot)-One does provide protection, One dose is given at least 2 weeks before exposure.
- Live typhoid vaccine (oral)-Its given orally in four capsules one capsule every other day for a week.the last dose should be given at least 1 week before exposure.
Complication of typhoid is generally occurring in a people who have been late treated. Commonly 2 major complications have seen 1st intestinal bleeding and intestinal perforation.
- Intestinal Bleeding-Intestinal Bleeding as a potential complication. the following are symptoms of intestinal bleeding. play skin, blood in stool, shortness of breath.
- Intestinal Perforation-A perforation intestine occurs in the small intestine or large bowel develop a hole causing intestine content to leak into abdominal cavities such as a severe abdominal pain, nausea, vomiting, and bloodstream infection.
- Myocarditis-Inflammation of the heart Muscles.
- Pneumonia-Along infection that develops by breathing in foreign material.
- Meningitis-Infection and inflammation of the membrane and fluid surrounding brain and spinal cord.
A vaccine in a recommendation for travel outside of there is typhoid fever.
- Rest and sleep-: The proper rest and sleep important for funding mind and body.
- Personal Hygiene-To maintains the proper personal hygiene it is important for the prevention of infection and maintaining of health.
- Diet- Proper intake diet food like fresh fruits and vegetables for maintaining a health.
- Medication-This is one of the most important to improve health Take medicine proper way and time to time.
- Do not eat food or drink beverages from street vendors.
- Drink only boil water.
- Prepare dinner all meals very well and eat it even as its hot.
- Preserve flies away from food.
- Peel off fruits and vegetable skins before eating.
- Avoid junk food intake.
- Maintain the personal hygiene.
- Use shield boltel mineral water during traveling.
- Avoid sharing spoon forks cloth towels of food with an infected person.