Typhoid fever is a very serious infectious disease that affects the stomach, intestines, spleen, liver, and blood vessels. It proceeds with pronounced signs of intoxication. The causative agent is the bacterium S.typhi, which is quite resistant to the environment. Penetrating into the human body, it begins to produce very strong toxic substances, which determine the occurrence of symptoms and the severity of the disease.
You can only get infected from a sick person or a he althy carrier of pathogens.
Typhoid
The abdominal type is an acute infectious disease that affects the intestines and lymph nodes. It is accompanied by an increase in the spleen and liver, fever, severe intoxication, and clouding of consciousness. Despite the fact that in recent years the incidence of the disease has greatly decreased, however, the problem is still quite relevant.
The causative agent of typhoid fever is Salmonella, which belongs to the Enterobacteriaceae family. In appearance, it resembles a short stick with a littlerounded ends. Its shell is densely covered with flagella, which prevent the active movement of bacteria.
An important feature of the causative agent of typhoid fever is the ability to produce endotoxin. In fact, it is a poison that is inside salmonella. However, if her death occurs, then toxic substances penetrate into the blood, provoking very severe intoxication or poisoning of the body. It is with this that the main manifestations of the disease are associated.
Salmonella typhoid is characterized by the fact that it does not form capsules and spores at all, but at the same time it can remain in the environment for a long time. Especially often you can find such a bacterium in dairy products, salads with mayonnaise, as well as minced meat. In them, it not only persists for a long time, but also actively reproduces.
If the causative agent of typhoid enters the body with strong immunity, then it is transformed. Due to this property, the bacterium does not die. When it is excreted through the intestines and enters a sensitive organism, it again acquires its disease-causing qualities. Only disinfectant solutions or heat can destroy it completely.
Feature of the disease
Typhoid fever is an anthroponotic disease, which manifests itself in the rapid development of fever, intoxication, changes in the intestines, and various rashes. In terms of its epidemiological features, development and symptoms, the disease is quite similar to the paratyphoid group. Typhoid fever and paratyphoid types A, B and C form a separate class of pathologies. On thefor a long time, they were considered a mild form of typhus with erased symptoms.
Typhoid fever and paratyphoid fever have been found to be caused by various types of Salmonella, which lead to the formation of very serious intestinal lesions. Such microorganisms are resistant to low temperatures, but are characterized by high sensitivity to heat. At a temperature of 60 degrees, salmonella dies in 30 minutes, and when boiled, this process takes a few seconds.
Food is considered the most favorable breeding environment. Typhoid fever is an infection that affects the intestines. This disease is characterized by a pronounced summer-autumn seasonality. Most often, typhoid fever is diagnosed in people aged 15-45.
The greatest danger in terms of infection is hidden bacteria carriers, that is, those who have had the disease in an erased form. They are unaware that they are ill and may be the main cause of typhoid outbreaks, especially if they work with food.
After the infection, a stable immunity is formed. In some cases, reinfection may occur.
Classification
According to the nature of the clinical picture, typhoid fever is divided into such forms as typical and atypical. The pathological condition can be acute and proceed with periods of relapse and remission. The severity of the infection can be:
- easy;
- moderate;
- heavy.
Depending on the severity, typhus can be complicated anduncomplicated. It is very important to recognize the symptoms of infection in a timely manner, as well as to carry out diagnostics and comprehensive treatment.
Causes of occurrence
The main cause of intestinal infection is Salmonella bacteria. Transmission of typhoid fever occurs from a sick person. Penetrating into the body, salmonella goes through several stages that are very difficult to prevent. The high concentration of pathogens causes the bacteria to quickly enter certain parts of the small intestine.
Active reproduction of salmonella in the intestinal mucosa provokes an inflammatory process, resulting in enteritis. Since the lymphatic system cannot keep the pathogen, this becomes the main reason that the infection enters the systemic circulation. Internal organs are damaged.
Because pathogens circulate through the circulatory system, it causes poisoning of the whole body. If complex therapy is not carried out in a timely manner, then the presence of bacteria in the body will be cyclical, destroying the spleen, liver, and lymph node tissues along the way.
Main symptoms
Latent course of typhoid fever at the initial stage greatly complicates the definition of infection at the very beginning of its development. In some cases, acute symptoms are observed from the very first days. The symptoms of typhoid fever are often progressive and appear as:
- slowly rising temperature;
- general weakness of the body;
- muscle and headache;
- nausea and vomiting;
- signs of intoxication;
- loss of appetite;
- sleep disorders.
Fever can last for 2-3 weeks. In dynamics, a constant change in body temperature is observed. In addition, there may be symptoms of typhoid fever, such as dry skin and extreme pallor.
About 8-10 days, a skin rash is added to the fever, going all over the body. The spots can reach considerable sizes, about 3 mm in diameter. If you lightly press this spot with your finger, then a pale color will appear on it. The rash can remain on the skin for up to 5 days, and if the disease is severe, the rash takes on a special form with bruising.
The occurrence of a reddish rash can be observed throughout the course of the disease, but with a lesser degree of intensity. During a general examination, you can notice a thickening of the walls of the tongue, and when you click on it, a characteristic mark remains. In addition, there is a white coating in the basal region of the tongue.
Among the main signs of typhus are flatulence, weakening of the intestines, and rumbling in the stomach. The patient often complains of difficult defecation.
At the initial stage of the course of the disease, a cough is observed, and when listening to the lungs, dry or moist rales are heard. With an exacerbation of typhoid fever, there may be mild bradycardia that occurs against the background of a strong increase in temperature. Against the backdrop of general weakness, there is a decreasepressure and muffled heart rate. In the most severe course, the progression of the signs of the disease occurs, expressed in:
- severe intoxication;
- conscious retardation;
- hallucinations.
After the temperature can be lowered, the patient's he alth immediately begins to improve. The subsequent exacerbation has much less pronounced symptoms. At the same time, the temperature is not high, but a rash may appear all over the body.
Erased form of the disease is characterized by the rapidity and short duration of all available signs. Exactly the same symptoms appear during a relapse of the disease, which can occur if a person interrupts treatment on his own, violates the diet, and various psycho-emotional factors affect his body.
Diagnostics
Typhoid fever is considered quite a dangerous disease, the transmission routes of which come from a sick person. Despite the fact that a dangerous disease is quite rare, it can make it difficult to diagnose even a qualified doctor. It is important to be able to distinguish it from other pathologies that are accompanied by severe intoxication of the body, as well as high fever.
Similar symptoms provoke diseases such as dysentery, typhoid fever, cholera, pneumonia, malaria. Typhus can be distinguished from other pathologies only by characteristic symptoms. If it lasts more than 5 days, then the doctor may prescribe a number of laboratory tests that will help determinecausative agent of pathology. Tests for typhoid fever include:
- complete blood count;
- urinalysis;
- biochemical analysis.
A blood test determines the amount of all contained elements. At the same time, there is an increase in leukocytes, lymphocytes, as well as ESR. When testing for typhoid fever, casts, erythrocytes, and protein are found in the urine.
Besides this, a bacteriological study is required. For laboratory diagnosis of typhoid fever, urine, blood, feces and bile are taken. They are sown in a nutrient medium and placed in a thermostat, where the temperature is maintained at 37 degrees all the time. If salmonellae are present in the assays, they form colonies, which can then be examined under a microscope. To detect bacteria, you need to take a blood test for typhoid fever. It should be noted that pathogens can be in a sick person, as well as a bacillicarrier.
The earliest and most accurate diagnostic method is blood culture. Bacteria appear in the blood during the incubation period and remain until the end of the course of the disease. For the study, blood is taken from a vein, and then it is sown on a nutrient liquid medium. You can get a preliminary result in 2 days.
In addition, bacteria can be isolated from feces, since salmonella in the intestinal contents are present from 8-10 days of the course of the disease. Starting from 2 weeks, special antigens are detected in the blood. These are particles of the shell and flagella of Salmonella. They can be determined usingresearch based on the response of the immune system. The analysis is carried out by taking blood from a finger, from which serum is then isolated.
Features of treatment
If there is the slightest suspicion of the course of typhoid fever, urgent hospitalization of the patient in the infectious diseases department is required. It is very important to properly adjust the patient's daily routine. To prevent the development of complications, bed rest is prescribed up to the 7th day of normalization of temperature. The patient is allowed to walk only after 10-12 days of normal temperature.
It is important to follow a strict diet. At the same time, food must be liquid, mashed, easily digestible and contain all the required vitamins. Usually, the patient is prescribed fermented milk products, broths, liquid cereals, minced meat, juices.
Typhoid cannot be treated without antibiotics. The typhoid bacillus is very sensitive to ampicillin, as well as its derivatives, in particular, Biseptol or Levomycetin. In addition, there is a special vaccine. The severity of the course of the disease is due to endotoxin, which is why infusion therapy is carried out. If indicated, cardiovascular drugs, vitamins and sleeping pills may be prescribed.
Traditional medicine gives a good result, but they should be used in combination with medications. You also need to consult a doctor first.
Medicated treatment
Cholera and typhoid fever have similar symptoms, which is why it is very important todiagnose in order to prescribe the correct treatment. The patient is hospitalized in the infectious diseases department, where the patient will have to spend at least a month. During therapy, it is imperative to observe strict bed rest. This will prevent rupture of the intestine and the occurrence of internal bleeding. It is very important to try not to lift heavy objects or even strain when going to the toilet.
Treatment is carried out in several directions at once. Initially, salmonella must be eliminated, for which antibacterial drugs are prescribed. Basically, "Ampicillin" or "Levomycetin" is used in tablet form or intramuscularly 4 times a day for a month. In severe forms of damage, a combination of antibiotics "Gentamicin" and "Ampicillin" is prescribed. In addition, the doctor can prescribe a new generation of funds, namely, Ciprofloxacin, Azithromycin.
If antibiotics do not have the desired effect or are poorly tolerated by the body, then the doctor may prescribe antimicrobial agents, for example, Bactrim, Cotrimoxazole, Biseptol, Septrim. The use of this remedy is shown 2 tablets 2 times a day. The course of therapy is approximately 3-4 weeks.
Be sure to take certain measures to eliminate intoxication, and also try to prevent dehydration - drink as much liquid as possible to remove toxic substances. The amount of liquid drunk should be at least 2.5-3.0 liters per day. If this amount isis not enough, enterosorbents are additionally prescribed. These drugs help absorb toxic substances in the intestines. To do this, appoint "Polifelan", "Smecta", "Enterodez".
In a moderate condition of the patient, it is necessary to cleanse the intestines and blood. For this, intravenous administration of glucose-s alt solutions is indicated so that toxins are excreted by the kidneys much faster. Such preparations as Quartasol, Laktasol, Acesol are used. If intoxication intensifies, then Prednisolone is prescribed in tablet form. The course of therapy is carried out for 5 days. Very well helps to cope with intoxication oxygen therapy. To do this, oxygen is introduced using catheters, or the patient is placed in a special pressure chamber. If the drugs do not help and the state of he alth continues to deteriorate, then the patient is given a blood transfusion.
During the course of the disease, the bone marrow does not produce the required number of leukocytes to maintain normal immunity. To enhance their production and speed up the process of intestinal recovery, drugs such as Pentoxyl and Methyluracil are prescribed. They are taken in tablet form after meals. Ascorutin will help to improve the functioning of capillaries, normalize metabolism and blood circulation.
If there is a suspicion of bowel perforation, a surgeon's observation is indicated. Discharge from the hospital is possible on the 21st day of normalization of temperature.
Folk remedies
Some plants have quite powerful bactericidal qualities, which is why they were previously used in folk medicine inas a prophylactic against typhoid fever. Calamus and garlic have proven themselves very well. The latter was consumed as food and constantly carried with them. Calamus rhizomes were cleaned, washed, and then chewed fresh.
For treatment during epidemics, decoctions of wild rose and blackcurrant, as well as coffee with lemon, were often used. Infusions of medicinal herbs help to significantly accelerate the healing of ulcers in the intestines, as well as cleanse the blood of toxic substances. This requires 1 tbsp. l. burnet roots pour 1 tbsp. hot water and boil for 30 minutes. Take the prepared remedy for 1 tbsp. l. every 2-3 hours.
St. John's wort helps well, which should be taken as a decoction or infusion throughout the day. You can prepare a healing remedy based on sage, centaury and chamomile. The prepared collection must be poured with hot water, insisted for 30 minutes, and then taken 1 tsp.
Folk remedies can be a very good addition to the basic drug therapy prescribed by an infectious disease doctor. It is worth remembering that it is forbidden to carry out treatment on your own, as this can only provoke a deterioration in well-being and lead to the development of dangerous complications.
Dieting
When typhoid fever occurs, a sparing diet is required. Food should not linger in the intestines for a long time, irritate it and provoke a copious secretion of bile. Doctors recommendeat foods steamed and then rubbed through a sieve or chopped in a blender. Food must be warm, washed down with a small amount of water.
Fresh pastries, alcoholic drinks, fried and fatty foods, carbonated drinks, fresh vegetables and fruits, condiments, pickles and confectionery are strictly prohibited. You need to consume food 5-6 times in small portions. Overeating should not be allowed, as well as feeling hungry for a long time.
After discharge from the hospital, you can begin to gradually expand the menu. Do not immediately eat fatty and smoked foods. Over the course of 7-10 days, new foods should be gradually introduced into the diet.
Hygiene
It is imperative to timely determine the presence of salmonella in the body, as well as conduct a comprehensive treatment. In addition, it is required to exclude ways of transmission of infection. To do this, the sanitary and epidemiological station conducts a thorough monitoring of the state of drinking water and sewage. Workers who are directly involved in the food preparation process should be tested for pathogens.
Everyone should definitely take care of their own he alth, especially in countries where typhus is widespread. It is important to follow the simplest safety rules, namely:
- consume only purchased water;
- purchase prepared meals that have been well cooked orfried;
- do not buy food on the streets;
- wash hands thoroughly after using the toilet and before eating;
- don't swim in open water where sewage can seep in.
Compliance with simple rules of hygiene can protect against this serious and dangerous disease. In addition, it is important to comply with the basic measures for the prevention of typhoid fever according to the SP established by the sanitary and epidemiological station of each particular region.
Possible Complications
If the treatment prescribed by the doctor is not carried out in a timely manner, various complications of typhoid fever may occur. The most unfavorable consequence is death. It is mainly seen in debilitated patients or young children.
Another consequence is re-infection or bacterial carriage. The causative agent of the disease is very stable and often, even during antibiotic therapy, remains in the liver and bile ducts. With a decrease in immunity, the clinical picture may repeat again.
In the acute period of the course of the disease, the most dangerous complication may be intestinal bleeding or damage to the intestinal walls, followed by the development of peritonitis. From the side of the nervous system, meningoencephalitis can develop. In addition, there may be damage to other organs and systems that manifest as otitis media, myocarditis, osteomyelitis, pneumonia, cholecystitis. Consequences may appear even several months after clinical recovery. That is why, patients who have had this infection for a long timemust be monitored.
Prophylaxis
Prevention of typhoid fever and paratyphoid fever is the main way to combat this disease. It includes a whole range of different activities, many of which are controlled by the he alth system. Among the main measures to highlight:
- compliance with sanitary standards;
- he alth monitoring;
- vaccination.
Prevention of typhoid fever implies compliance with the rules for transporting products, monitoring the state of water, as well as maintaining personal hygiene. It is important to monitor the condition of people on whom the mass spread of infection depends. Upon contact with an infected person, medical observation is required for 21 days. At the same time, it is imperative to conduct studies of urine, blood and feces for the presence of salmonella in the body.
Vaccination against typhoid fever is an important preventive measure, which ensures the maintenance of good immunity for a long time. Vaccination will avoid infection when salmonella enters the body. If a person does get sick, then the disease will proceed in a milder form. Recovery will occur in about 7-14 days.
Because children get infected much more often, they need the typhoid vaccine the most. That is why in regions with an unfavorable epidemiological situation, it is necessary to vaccinate people aged 5-19 years. The effectiveness of vaccination from different manufacturers is not toovaries greatly.
Since typhoid fever is a rather dangerous disease, it is imperative to carry out its timely diagnosis and comprehensive treatment.
