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Typhoid fever


Acute infectious disease caused by a bacterium from the genus Salmonella. The pathogen can be stored in soil and water for up to 1-5 months. Dies when heated and the action of conventional disinfectants.
The only source of infection is a sick person and a bacterium carrier. Typhoid sticks are carried directly by dirty hands, flies, and sewage. Outbreaks associated with the use of infected food (milk, cold meat dishes, etc.) are dangerous.
Symptoms and course:
The incubation period lasts from 1 to 3 weeks. In typical cases, the disease begins gradually. Patients noted weakness, fatigue, mild headache. In the following days, these phenomena increase, the body temperature begins to rise to 39-40 "C, the appetite decreases or disappears, sleep is disturbed (drowsiness during the day and insomnia at night). There is a delay in stool and flatulence. By the 7-9 day of the disease on the skin of the upper sections abdomen and lower parts of the chest, usually on the anterolateral surface, there is a characteristic rash, which is a small red speckles with clear edges, 23 mm in diameter, towering above the skin (roseola). Characterized by a kind of inhibition of patients, pallor of the face, slowing of the pulse and lowering of arterial pressure. Dispersed dry hryns are heard above the lungs - a manifestation of specific bronchitis. teeth imprints. There is a rough rumbling of the cecum and pain in the right iliac region, the liver and spleen on palpation are increased. The number of leukocytes in peripheral blood is reduced, especially neutrophils and eosinophils.
ESR remains normal or increases to 15-20 mm / h. By week 4, the condition of the patients gradually improves, the body temperature drops, the headache disappears, appetite appears. Terrible complications of typhoid fever are intestinal perforation and intestinal bleeding.
In recognizing the disease, timely identification of the main symptoms is of great importance: high body temperature lasting more than a week, headache, weakness - decreased motor activity, loss of strength, sleep disturbances, appetite, characteristic rash, sensitivity to palpation in the right iliac abdomen, enlarged liver and spleen. From laboratory tests, the bacteriological (immunofluorescent method) blood culture on Rappoport or gall broth is used to clarify the diagnosis; serological studies - Vidal reaction and others.
Treatment:
The main antimicrobial drug is chloramphenicol. Assign at 0.50.75 g, 4 times a day for 10-12 days to normal temperature. A 5% glucose solution, an isotonic sodium chloride solution (500-1000 mg) is injected intravenously. In severe cases - corticosteroids (predizolon at a dose of 30-40 ml per day). Free must observe strict bed rest for at least 7-10 days.
Prevention:
Sanitary supervision of food enterprises, water supply, sewage. Early detection of patients and their isolation. Disinfection of the room, linen, dishes that boil after use, the fight against flies. Clinical supervision of patients with typhoid fever. Vaccine specific vaccine (TAVTe).