Typhoid fever

Typhoid fever is still a public health problem in the world, especially in developing countries with poor sanitation, including Indonesia.  The World Health Organization estimates that there are 17 million cases of typhoid fever worldwide with an incidence of 600 thousand deaths each year.

Typhoid is an infectious disease listed in Law number 6 of 1961 concerning outbreaks. This group of infectious diseases includes diseases that are easily transmitted and can attack many people so that they can cause an outbreak.

Typhoid fever is an acute small intestine infection caused by Salmonella Typhii (S.typhii) with fever for one week or more accompanied by gastrointestinal disorders and with or without impaired consciousness.

Salmonella bacteria can live up to several weeks in the wild such as in water, ice, garbage and dust.  It can die by heating (at temperature 60C) for 15-20 minutes, pasteurization, boiling and chlorination.

Typhoid fever can attack when the germs enter through food or drink, resulting in an infection of the digestive tract; in the small intestine.  And through blood circulation, germs reach certain organs, especially the liver and spleen.  It then multiplies in the liver and spleen, causing pain when touched.  The incubation period (shoots) of typhoid fever lasts between 10-14 days.

Clinical symptoms of typhoid fever:

• High fever from 39.0 C – 40.0 ​​C which increases slowly from late afternoon to early morning.
• Body shivering
• Weak heart rate (bradycardia)
• Body weakness
• Severe headaches at night, especially in the back of the head.
• Muscle pain (myalgia)
• Loss of appetite
• Constipation
• Stomach pain (discomfort in the stomach)
• In certain cases, a spread of pink spots (rose spots) appears.
• Dirty tongue in the middle, red edges and tips, tremor

Laboratory results that can be done to support the diagnosis is with widal in which there is an increase in antibody titers O or H.  Or it can also be done with Tubex TF to check for antibodies against these germs.  Blood culture to check for positive blood culture results for germs

Treatment of typhoid fever is carried out with a management trilogy, which are:

• Rest & care, advice for bed rest and personal hygiene.
• Diet & supporting therapy, filtered porridge diet which is then increased to coarse porridge until finally given rice.
• As well as administration of antimicrobials, with the main choice of drug, which is chloramphenicol or can be replaced with other drugs if there is an allergy to the main drug.

Complications

• Bowel perforation
• Paralytic ileus
• Intestinal bleeding
• Hepatitis
• Myocarditis
• Bronchopneumonia
• Pleuritic
• Disseminated intravascular coagulation
• Sepsis

Prevention strategies are more directed at the availability of clean water, avoiding contaminated food, personal hygiene, good sanitation, and administering vaccines as needed.

Source:

perbidkes.com. Ugm.ac.id, penyakittifus.com, emedicine.medscape.com