TYPHOID TIPS
- 1. TYPHOID FEVER PREPARED BY: ISAAC EDIANGU MEDICAL CLAIMS ASSESSOR RCN,*BScN
- 2. SALMONELLA SPECIES Rod-shaped bacilli Motile Non-spore forming Aerobic and anaerobic Gram negative Have a cell wall composed of a thin layer of peptidoglycan covered by a membrane
- 4. PATHOLOGY Incubation Period In urine it is during the second week after infection In blood, it is detected during the first 10 days In feces; detected during the second to third week Mode of Transmission It is mainly the fecal-oral route through ingestion of the bacteria. Person-to-person through direct contact with the carrier of Salmonella. Animal-to-person especially those who have pets. Foodborne through improperly cooked food like milk, meat, eggs, salads.
- 5. PATHOLOGY Enteric fever infection begins in the small intestines but few gastro intestinal symptoms occur The bacteria enters and multiplies in the mononuclear phagocytes of peyer’s patches then spreads to the phagocytes of the liver, gall bladder and spleen leading to bacteremia Enterocolitis; characterized by an invention of the epithelial and sub-epithelial tissue of the small and large intestines The organisms penetrate both through and between the mucosal cell into the lamina propria leading to inflammation and diarrhea Bacteria can pass through the intestines into the bloodstream and into the liver, spleen, bone marrow, and gall bladder Bacteria from the gall bladder can re infect the intestines, producing gastroenteritis and a recurrence of bacteremia
- 6. PATHOLOGY Adverse complication: Ulcerate and perforate the intestinal wall Peritonitis Cluster Headache Destruction of normal flora; hence prebiotics use It complicates or can be complicated by gastritis, PUD Typhoid fever outbreak
- 7. PATHOLOGY
- 8. PATHOLOGY Salmonella typhi is a major public health problem globally in developing countries Over 21 million new cases reported annually, with increasing resistance to previously used antimicrobials and deaths of 200,000 people In Uganda, 210,000 new cases and 200,000-600,000 deaths as per 2013-2016 Uganda medical statistics Non-typhi Salmonellae (NTS): Salmonella typhimurium and Salmonella enteritidis are the common cause of bacteremia and septicemia
- 9. Diagnosis
- 10. Treatment Enterocolitis is a self resolving disease which usually does not require treatment Enteric fevers with septicemia may require antibiotics which include: – Quinolones; ciprofloxacin, ofloxacin – Cephalosporins; ceftriaxone, cefotaxime Treatment can also be through replacement of fluids and electrolytes
- 11. Prevention Proper hand washing before eating and after toilet use Proper sewage and waste management or treatment Proper cooking of poultry eggs and meat Covering all food and proper food handling Pasteurization of milk Culture of stool and samples from food handlers Notification of Salmonellae infection out break Vaccination to provide temporary protection to travelers going to endemic areas
- 12. Key Facts