Typhoid fever

Mar 10, 2017,
Typhoid fever is about the most common misdiagnosed illness in Nigeria. It is not as common as many will think. It is a disease attributed to poor hygiene, mainly seen amongst those in the lower socioeconomic cadre of the society. It is mainly seen in the rural settings where hygiene is usually neglected. Typhoid fever is a faeco-oral infection (that means, for you to have typhoid fever, you must have ingested food or fluid that came in contact with the faeces of someone who has typhoid). It is a very fatal multisystemic illness caused primarily by Salmonella enterica (typhi and, to a lesser extent, paratyphi A, B, and C). It usually presents with high grade continuous fever that peaks in a stepwise manner, malaise, generalized abdominal pain, and constipation or diarrhea. Untreated, typhoid fever may progress to delirium, intestinal bleeding and perforations, and death within one month of onset. Survivors may be left with long-term or permanent psychiatric complications. In the first week of the disease, its famous gastrointestinal manifestations develop. These include generalized abdominal pain and tenderness and, in some cases, severe colicky right upper quadrant pain. The individual may develop a dry cough, dull frontal headache and delirious. The second and third weeks are characterized by worsening of the symptoms, the abdomen becomes distended, and the spleen becomes enlarged. The patient becomes more toxic, with severe weight loss and intestinal perforations which might lead to death if not treated and operated on. If the patient survives up to the fourth week, the symptoms improve, the individual may become asymptomatic and becomes a life long carrier. Culture of the bone marrow aspirate, blood or intestinal secretions are the standard diagnostic tools for typhoid fever. They are 100% specific. Widal test is neither sensitive nor specific for salmonella typhi, it (Widal test) is no longer an acceptable clinical method. It is paramount to prevent this disease by practicing, teaching and enforcing good hygienic practices. Individuals with such symptoms should visit the nearest hospital and should not indulge in self medications. It is dangerous to abuse antibiotics. Let us all fight this ever rising misdiagnosis, while we still indulge in safe hygienic practices. Thank you for reading. Dr Uche Iwenobi-Njoku
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By Uche Iwenobi-Njoku (ID: DOC414)       Comments       Rating: