Typhoid fever, Eteric fever,

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TYPHOID FEVERDr.Rahul.K.RDept. of SwasthavrittaAmrita School of Ayurveda

Typhoid FeverFever cased due to a systemic infection caused by Salmonella typhi.Found only in man.Characterized by continues fever for 3 to 4 weeks.Relative BradycardiaSphygmothermic dissociation or Faget sign. {Liebermeister's rule ( In normal fever)}Lymphoid tissue involved with constitutional symptoms.Also called Enteric feverDisease occur sporadically, epidemically or endemically.

Faget sign in bacterial infections is consistently associated with bacteria that have an intracellular life cycle.Liebermeister's- 1degree rise in temp ---8 beats /minConstitutional symptomsrefers to a group ofsymptomsthat can affect many different systems of the body. Examples include weight loss, fevers, fatigue, and malaise. 2

Problem statementOccurs in all part of the world with sub standard water supply and sanitation.Uncommon in developed countries.Developing areas of Asia, Africa Latin America the disease became a public problem.In 1940 introduction of antibiotics reduce mortality and morbidity rate drastically.2004 WHO estimates the typhoid fever burden @ 21million cases / year of which 2,16,000 6,00,000 death/year.In 1950 antibiotic resistant organism became a growing problem

Problem statement (WORLD)1989 drug resistance was reported in many countries. >50% strains in Asia may already be resistant to most of antibiotics.MDR strains become resistant to all 3 first line antibiotics.ChloramphenicolAmpicillincortimoxazoleCompared with sensitive strain a 10 fold higher rate of post treatment symptomatic bacterial carriers are reported with MDR S.typhi infection.Without effective treatment the fever kills 10% of the infected.Huge socio-economic impact because typhoid survivors take several months to recover.

High endemicity (>100 cases per lac per year) Medium endemicity (10 cases per lac per year) Low endemicity (