Typhoid fever

Typhoid fever

Typhoid fever is an infectious disease caused by the bacterium Salmonella typhi. This infectious disease is generally transmitted through food or drink contaminated with the patient's feces or urine. If not handled properly, this disease can cause complications that are fatal.

Typhoid fever or typhus occurs a lot in Asian countries, including Indonesia. In Indonesia, typhoid fever is classified as an endemic disease. It is estimated that 500 out of every 100,000 Indonesian people get typhoid fever every year.

Although both are caused by Salmonella bacteria , typhoid fever is different from Salmonella infection (salmonellosis). Salmonellosis is caused by Salmonella bacteria , while typhoid fever is caused by one type of Salmonella bacteria, namely Salmonella typhi.

Typhoid fever or typhus is also different from typhus or typhus . Typhus is caused by the bacteria Rickettsia and Orientia .

Causes of Typhoid Fever

Typhoid fever is caused by the bacterium Salmonella typhi. These bacteria can enter and develop in the intestine after a person consumes food or drink contaminated with feces or urine of a patient with typhoid fever.

Salmonella typhi can also be transmitted from patients who are no longer symptomatic, but still carry the bacteria. This happens because the cure has not been done completely so that Salmonella typhi is still left in the intestine and can be transmitted to other people.

Risk factors for typhoid fever

Although typhoid fever is more common in children, there are a number of other factors that can increase a person's risk of developing typhoid fever, namely:

  • Visiting or working in an area with a high incidence of typhoid fever
  • Make direct contact with typhoid fever sufferers
  • Living in a dirty and poorly sanitized environment
  • Work as a health worker who treats typhoid fever sufferers
  • Eating unwashed vegetables or fruits
  • Using the same toilet with the patient and not washing hands afterwards
  • Eating seafood from water contaminated with bacteria
  • Having sex through the mouth ( oral sex ) with typhoid fever sufferers

Symptoms of Typhoid Fever

Symptoms of typhoid fever appear 7-14 days after a person is infected with the bacterium Salmonella typhi. How long symptoms last depends on the progression of the disease.

Typhoid fever sufferers may experience initial symptoms in the form of:

  • Fever that increases gradually until it reaches 39–40°C
  • Headache
  • Muscle ache
  • Tired and limp
  • Excessive sweating
  • dry cough
  • Loss of appetite
  • Weight loss
  • Stomach ache
  • Constipation
  • Red rash on the skin
  • Swelling in the abdomen

If the disease worsens, typhoid fever can cause further symptoms, such as:

  • Dazed or delirious
  • Hallucinations
  • Diarrhea
  • shivers
  • Body feels very tired
  • Difficult to concentrate
  • bloody CHAPTER

When to go to the doctor

Immediately see a doctor if you experience the symptoms mentioned above, especially if you have just traveled to an area with a high case of spreading typhoid fever. It should be noted that people who have received the typhoid vaccine are still at risk of developing typhoid fever.

Even though the symptoms of typhoid fever are almost the same as the symptoms of other infections, you should still see a doctor. Early examination is needed to confirm the condition and prevent the risk of complications.

Typhoid Fever Diagnosis

The doctor will ask questions and answers about the symptoms, as well as the patient's medical history and travel. After that, the doctor will carry out a physical examination by measuring body temperature, looking for reddish rashes on the skin, and pressing on the stomach to check for swelling in the liver or spleen.

To confirm the diagnosis, the doctor will perform a number of further examinations, namely:

  • Blood, urine and stool tests, to detect the presence of Salmonella typhi bacteria
  • Bone marrow aspiration , to further confirm the presence of Salmonella typhi bacteria from the results of blood, urine and stool tests, but this test is rarely done
  • Widal test , to detect antibodies against Salmonella typhi bacteria
  • TUBEX TF test, to detect antibodies against Salmonella typhi bacteria with a higher sensitivity than the Widal test

It should be noted that in areas where typhoid fever is endemic, such as Indonesia, almost all of the population has been exposed to Salmonella typhi bacteria. This makes the body naturally form antibodies against these bacteria .

Since the Widal test works by detecting antibodies to the bacterium Salmonella typhi , this test can give a positive result even if the patient does not have typhoid fever. Therefore, in determining the test results, doctors will be more careful to get an accurate diagnosis.

Typhoid Fever Treatment

Typhoid fever is treated depending on its severity. If typhoid fever is detected early and causes only mild symptoms, the patient can perform self-care at home. Generally, the doctor will give some of the following medicines:

  • Antibiotics , such as ciprofloxacin , ceftriaxone, and azithromycin , to treat bacterial infections, which should be taken for 2–3 weeks
  • Fever-reducing drugs, such as paracetamol

Unfortunately, many Salmonella typhi bacteria have become resistant to the antibiotics chloramphenicol , ampicillin, and co-trimoxazole. Therefore, antibiotics must be prescribed by a doctor and taken by the patient to completion, and evaluated by a doctor.

Meanwhile, in cases with severe symptoms, patients need to be hospitalized. The doctor will give antibiotics by injection and intravenous fluids to prevent dehydration . If needed, the doctor can also perform surgery, especially if the patient has bleeding or tears in the digestive tract.

During the treatment period, patients are also advised to do the following things to speed up the healing process:

  • Don't do strenuous activities
  • Get enough rest
  • Eat small portions, but often
  • Eat soft and non-spicy food if you can't eat solid food
  • Wash your hands with soap and running water regularly
  • Drink enough water

Complications of Typhoid Fever

If you don't get proper treatment, typhoid fever can cause several complications. Some of the most common complications are:

  • Bleeding in the digestive tract requiring blood transfusions
  • Tears in the digestive tract, which can develop into peritonitis and be fatal

Apart from the complications above, there are several other complications that can arise, namely:

  • Inflammation in the heart muscle ( myocarditis )
  • Bladder infection
  • Kidney failure
  • Inflammation of the inner lining of the heart (endocarditis)
  • Meningitis
  • Vascular infection
  • Pneumonia
  • Pancreatitis

Typhoid Fever Prevention

One effort to prevent typhoid fever is to get a typhoid vaccine. This vaccine is included in the immunization program recommended by the government. Although generally given to children aged 2–12 years, the typhoid vaccine can also be given to adults who are at risk of developing typhoid fever.

Apart from vaccines, there are several other preventive measures that can be taken, namely:

  • Frequently wash hands with soap and running water
  • Avoid consuming raw fruits and vegetables that are not washed with clean water
  • Make sure the water to be drunk has been boiled until cooked
  • Avoid consuming raw or immature foods
  • Limiting the consumption of snacks and drinks sold on the roadside
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