Typhoid.pptx

Typhoid.pptx

1. TYPHOID PRESENTED BY : V.RAMYA, TUTOR

2. TYPHOID

3. TYPHOID Typhoid, also known as typhoid fever, is a life-threatening disease that is caused due to an infection by a bacteria named Salmonella typhi.

4. Epidemiology Typhoid fever occurs worldwide, primarily in developing nations whose sanitary conditions are poor. It is endemic in Asia, Africa, Latin America, but 80% of cases come from Bangladesh , China , India, Indonesia, Nepal , Pakistan, Within these countries, typhoid fever is the most common in underdeveloped areas. Typhoid fever infects roughly 21.6 million people (incidence of 3.6 per 1,000 population) and kills an estimated 200,000 people every year (Medscape ). In 2011, 1.06 million cases and 346 deaths were reported in India. The prevalence rate is 88 cases/lac population and death rate is 0.029/lac population.

5. Etiology The causative organism of typhoid, Salmonella typhi, is present only in human beings and its transmission occurs through contaminated food or water. People who are infected carry the bacterium in their intestines as well as the bloodstream, and those who have recovered from the disease could still have the bacterium in their system; they are known as "carriers" of the disease.

6. Etiology Both the infected people and the carriers shed Salmonella typhi in their stool. Infection is usually spread when food or water is handled by a person who is shedding the bacterium, or leakage of sewage into water or food that is then consumed by healthy persons . So this disease is common in areas where proper hand washing techniques are not followed.

7. Pathophysiology Salmonella typhi Enters stomach and survives in its acidity Invasion of intestinal Peyer's patches Bacterium enters the macrophages and survives Spreads via lymphatics Access to reticuloendothelial system, liver, spleen, gallbladder, and bone marrow Emergence of the signs and symptoms (fever, abdominal pain, spleen enlargement, and spots) Necrosis of Peyer's patches Perforation and bleeding Death

8. Clinical Manifestations Once the bacterium is ingested by a person, it quickly multiplies within the parts of the body, for example, stomach, Iiver or gallbladder, and finally enters the bloodstream causing symptoms such as fever (usually between 103°F and 104"Th rashes (fat, rose-colored spots), vomiting, loss of appetite , headaches, general fatigue, and malaise .

9. Clinical Manifestations In severe cases, may suffer from intestinal perforations or internal bleeding diarrhea, or constipation . One of the characteristic features of typhoid is a "step ladder fever." This means that the fever gradually fluctuates between very high and low-degree fever for a short period of time, till it peaks at 103-104°F.

10. Clinical Manifestations In patients without any complication, the condition subsides in about 3-4 weeks after its onset. In about 10% of people , the condition relapses after about 1 week of convalescence.

11. DIAGNOSIS A CBC will show a high number of white blood cells (WBC S) A blood culture during the first week of the fever can show Salmonella typhi bacteria. Other tests that can help diagnose this condition include : ELISA urine test to look for the bacteria that cause typhoid fever Fluorescent antibody study to look for substances that are specific to typhoid bacteria Platelet count (platelet count may be low) Stool culture

12. DIAGNOSIS The Widal test was the main stay of typhoid fever diagnosis for decades. It is used to measure agglutinating antibodies against Medical Management Hand O antigens of S. typhi. Neither sensitive nor specific, the Widal test is no longer an acceptable clinical method.

13. MEDICAL MANAGEMENT Typhoid fever is treated with antibiotics that kill the Salmonella bacteria. With appropriate antibiotic therapy- there is usually improvement within 1-2 days and recover within 7-10 days . Several antibiotics are effective for the treatment of typhoid fever. Chloramphenicol was the original drug of choice for many years. Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics. If relapses occur, patients are retreated with antibiotics. Those who become chronically ill (about 3-5% of those infected) can be treated with prolonged antibiotics. Often , removal of the gallbladder , the site of chronic infection, provides a cure.

14. MEDICAL MANAGEMENT Chloramphenicol was the original drug of choice for many years. Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics. If relapses occur, patients are retreated with antibiotics. Those who become chronically ill (about 3-5% of those infected) can be treated with prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, provides a cure.

15. Supportive Therapy Other treatment steps aimed at managing symptoms include: 1. Drinking fluids-this helps to prevent the dehydration that results from a prolonged fever and diarrhea . In case of severe dehydration, IV fluids must be administered. . Eating a healthy diet— nonbulky , high-calorie meals can help replace the nutrients being lost from the body during the course of the disease.

16. Nursing Management Monitor vital signs Monitor the status of hydration. Assess for weight loss, nausea, and vomiting. Monitor intake of food and liquids, provide selected food, and involve the family in meeting the nutritional needs . Instruct the patient to enhance the intake of protein and vitamin C. Provide assistance to meet daily needs such as food and drink, change clothes, and watch oral hygiene, hair, genitalia, and nails. Collaborate with other medical teams for IV fluid administration.

17. Nursing Management Explain the purpose of bed rest to prevent complications and speed up the healing process Assess the level of pain, location, duration, intensity, and characteristics of pain. Review the factors that increase pain and decrease pain. Give warm compresses on the area of pain. Provide analgesics as prescribed by the physician. Assess the extent of knowledge of the patient about his or her illness. Give health education about the disease and treatment.

18. prevention If someone has suffered from typhoid, they should ideally not discontinue their medication abruptly or as soon as they feel better because typhoid has a high rate of relapse. It is important that the patient continues his/her medication until the doctor asks to stop. The patient must also ensure washing hands well with an antibacterial soap after going to the toilet and before touching any food or water .

19. prevention Today , there are vaccines that can protect from contracting typhoid. The Ty21a vaccine is administered intramuscularly and requires the patient to take a booster shot after 5 years. Even if a person has taken the vaccine, they should not expose themselves to possible infectious agents.

20. prevention Apart from the vaccine, there are some basic things that one can take care of in order to avoid contracting typhoid Do not eat food cooked on the road side . Do not eat fruits and raw vegetables that have been pre cut . Always drink either bottled water or boiled water. Do not have ice prepared locally . Wash hands well before cooking a meal or eating .

21. REFERENCES Brunner and Suddarth’s Textbook of Medical- Surgical Nursing ,South Asian Edition , Volume II , Published by Wolters Kluwer . Page reffered to 1528- 1529. https:// www.slideshare.net/hanasheque/typhoid-disease https:// www.slideshare.net/sapanathakor/typhoid-fever-ppt-124654652 https://www.slideshare.net/kuldeepvyas370/typhoid-232227753