Infectious diseases. Typhoid fever. Clinic. Complications. Diagnostics. Treatment (most important)

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Infectious diseases. Typhoid fever. Clinic. Complications. Diagnostics. Treatment (most important)

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4. Typhoid fever. Clinic. Complications. Diagnostics. Treatment

Clinical manifestations. In children, the disease manifests itself as mild gastroenteritis or severe septicemia. Vomiting, bloating, and diarrhea are common.

The incubation period of the disease in older children ranges from 5 to 40 days, more often 10-20 days. It is followed by the initial period of the disease, characterized by a gradual increase in body temperature, malaise, myalgia, headaches and abdominal pain, diarrhea, and less commonly, constipation. Within 1 week, body temperature becomes constant, malaise, anorexia, weight loss, cough, abdominal pain and diarrhea increase. The patient becomes inhibited, he develops depression, delirium and a stuporous state. Maculopapular rashes appear in 80% of sick children. They occur sequentially for 2-3 days and are found on the skin of the abdominal wall and lower chest in the form of spots with a diameter of 1-6 mm.

Complications. Typical complications for typhoid fever are intestinal bleeding and intestinal perforation, less often - neurological complications, acute cholecystitis, thrombosis and phlebitis. Pneumonia often complicates typhoid fever at the height of the disease.

Laboratory research methods. Normochromic normocytic anemia is observed in patients with typhoid fever who have intestinal bleeding or toxic suppression of bone marrow function. Leukopenia is rare. With the development of purulent abscesses, the number of leukocytes increases to 20-000 per 25 ml. Thrombocytopenia can be significantly pronounced and persists from several days to 000 week. Melena and proteinuria are associated with a feverish state.

Diagnosis. Typhoid fever is diagnosed on the basis of prolonged fever, headache, increasing intoxication with the development of "typhoid status", characteristic changes in the tongue, the appearance of flatulence, roseolous rash, hepatosplenomegaly and characteristic changes in the peripheral blood, as well as on the basis of the results obtained:

1) laboratory research;

2) serological diagnostics;

3) express diagnostics of typhoid fever. Treatment. Patients with typhoid fever are subject to mandatory hospitalization. Important in the treatment of children with typhoid fever is the maintenance of adequate hydration and electrolyte balance. The development of shock as a result of intestinal perforation or severe hemorrhage is an indication for the introduction of large amounts of fluid intravenously.

Treatment is carried out with drugs that have a bacteriostatic effect on typhoparatyphoid bacteria (levomycetin, ampicillin, rifampicin, amoxicillin, unazine, amoxiclav). Along with etiotropic treatment, antifungal drugs (nystatin, levorin, etc.), antihistamines are prescribed.

Author: Pavlova N.V.

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