Typhoid

Introduction

Continuous fever (39 degrees- 40 degrees C) without symptoms to cold and cough, but with headache, loss of appetite,, dullness, constipation, coated tongue and delirium points towards typhoid. History of contact with the patient having typhoid at home further adds to the suspicion. Some patient may feel chilly and have a slight cough. The abdomen may be slightly bloated. Later in the disease, the child may develop loose motions. The doctor will take note of above features. and would find an enlarged liver and spleen towards the end of the week.

Confirmation of diagnosis and Treatment

No antibiotic is given before collection of a blood sample for culture.  The hospital laboratory should be requested to observe the culture for one week as the organism may take sometimes to grow. In case of a strong suspicion, your doctor may decide to start the appropriate  antibiotic while waiting for the report. It may take a few days before response from the antibiotic is noticed.

If the blood grows typhoid organisms, the laboratory will test for the drugs to  to which the organism is most sensitive. Then the doctor may decide to continue the same medicine or change over to a new one that may also take a couple of  days to show a positive response.

Before a culture report comes , a total W.B.C count of less than 4000/mm raise to 3 may also be supportive of the diagnosis of typhoid. Another test commonly asked for is the Widal test. This becomes positive in the second week, but the result of this test losses its reliability if the antibiotic have been started too early in the course of disease.

Paracetamol can be given for the symptomatic relief of fever and headache. Sponging of the body with warm water can be done for lowering the temperature.

Prevention

The source of infection is contaminated water, ice, food and milk. The patient continuous to pass the germs of the illness in the stools for up to 3 months afterwards. Proper hand washing is essential.

Water must be boiled and cooled before consumed. Do not listen to those who say that on some occasion you may have to take unboiled water outside, and so it is useless to take boiled water at home. You must note that a large number of typhoid germs need to be swallowed to start the disease process.  So we should always aim at cutting down the bacterial load as much as possible.

Immunization can be done for prevention.

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