Friday, June 3, 2011

Typhoid Fever

Typhoid Fever

Typhoid Fever is usually called typhoid or types in the Indonesian language, is a disease caused by the bacterium Salmonella enterica, especially derivatives such as Salmonella Typhi mainly attacks the digestive tract. Typhoid fever is an acute infectious disease that always exist in society (endemic) in Indonesia, ranging from age five, children and adults.

According to dr. Arlin Algerina, SpA, of the International Hospital Bintaro, In Indonesia, estimated between 800 - 100,000 people were affected by the disease typhus or typhoid fever throughout the year. Fever is mainly appears in the dry season and is said girls are more often attacked, the current increase in cases occurred at ages under 5 years old.

How Typhoid Fever Transmission

Typhoid fever can strike when the germs enter through food or drink, resulting in infection of the digestive tract of the small intestine. And through the bloodstream, the bacteria reach the organs of the body especially the liver and spleen. He then proliferate in the liver and spleen that causes pain when touched.

Signs and Symptoms of Typhoid Fever

This disease can strike when the bacteria enter through food or drink, resulting in infection of the digestive tract of the small intestine. Then followed the bloodstream, the bacteria reach the liver and spleen that breed there, which causes pain when touched.

Clinical symptoms of typhoid fever in children usually give a mild clinical picture can be even without symptoms (asymptomatic). Broadly speaking, the signs and symptoms caused by, among others;
Fever more than a week. During the day usually looks fresh but before the night a high fever.
Tongue dirty. The middle part is white and red edges. Usually children will feel bitter tongue and tend to want to eat the sour-sour or spicy.
Weight nausea to vomiting. Salmonella typhi bacteria breed in hatidan spleen, the result is swelling and eventually suppress the stomach, causing nausea. Due to excessive nausea, eventually enter the food can not be perfect and usually come out again through the mouth.
Diarrhea or Diarrhoea. The nature of the bacteria that attacks the gastrointestinal absorption of fluid that causes the disorder eventually occurs diarrhea, but in some cases actually occur constipation (difficult bowel movements).
Weakness, dizziness, and abdominal pain. High fever cause a sense of weakness, dizziness. The occurrence of swelling of the liver and spleen causing pain in the abdomen.
Fainting, not unconscious. Patients generally feel more comfortable with a lie without much movement, but with the severe conditions often occur disturbance of consciousness.
Diagnosis of Typhoid Fever

To the accuracy of the enforcement of disease diagnosis, the doctor will perform several laboratory tests including peripheral blood examination, Widal examination and culture of bile.
Examination of peripheral blood is a simple examination that is easy to do in a simple laboratory to make the diagnosis quickly. There will be a picture of a reduced white blood count (lekopenia), which increased the number limfosis and eosinophilia.
Widal examinations are blood tests to find an anti against typhoid germs. Positive if the titer Widal O 1 / 200 or more and / or show a progressive increase.
Typhoid fever positive definite diagnosis when performed by the finding of bile cultures typhosa Salmonella bacteria in the blood when the first week and then often found in the urine and faeces.

Positive blood samples was made to establish a definitive diagnosis. Urine and faeces samples twice in a row are used to determine that the patient had completely recovered and not the germ carrier (carrier).

Meanwhile, to ascertain whether the illnesses suffered by patients is another disease it is necessary differential diagnosis. If there is a fever of more than five days, the doctor will think of possibilities other than typhoid fever are other infectious diseases such as paratyphoid A, B and C, dengue fever (dengue fever), influenza, malaria, tuberculosis (TB) and lung infection (pneumonia).

Care and Treatment of Typhoid Fever

Care and treatment of disease Typhoid fever or types aimed at stopping the invasion of bacteria, shortening the course of the disease, prevent complications, and prevent the recurrence did not return. Treatment of typhoid disease conducted by isolating patients and conduct disinfection of clothing, faeces and urine to prevent transmission. Patients must lie in bed for three days until the heat down, and then allowed to sit, stand and walk.

Apart from drugs given to reduce symptoms such as fever and dizziness (Paracetamol), For a child with typhoid fever, the main choice of antibiotic is chloramphenicol for 10 days and is expected to occur eradication / eradication of germs as well as treatment time is shortened. But there are some doctors who chose other antibiotics such as ampicillin, trimethoprim-sulfamethoxazole, cotrimoxazole, cephalosporins, and ciprofloxacin according to the patient's condition. Excessive fever causing the patient to be treated and given fluids infusion.

Complications of Typhoid Fever

Complications are often found in children with typhoid fever is intestinal bleeding due to perforation, infection of the gallbladder (cholecystitis), and hepatitis. Brain disorder (encephalopathy), sometimes found also in children.

Typhoid Fever Disease Diet

Typhoid fever disease patients during treatment should follow the dietary guidelines recommended by doctors for consumption, among others:
Food is quite fluid, calories, vitamins and proteins.
Does not contain much fiber.
Not stimulating and does not cause a lot of gas.
Food is provided during breaks.
To return to the food "normal", do it gradually along with the mobilization. For example, the first and second day of soft food, day-to-3 regular meals, and so on.

Typhoid Fever Prevention

Typhoid fever prevention of diseases can be done by improving hygiene and environmental sanitation and health education. Immunization using oral vaccines and vaccine injections (antigen Vi Polysaccharida capular) has been widely used. Currently, prevention of Salmonella bacteria can be done with named chotipa vaccination (cholera, typhoid, paratyphoid) or TIPA (typhoid-paratyphoid). For children aged 2 years who are still vulnerable, can also be vaccinated.

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