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    Typhoid Fever in Children: A Hospital Based Follow-Up: Department of Child Health

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    Typhoid Fever in Children: a hospital based follow-up discusses the history and current state of typhoid fever, which primarily affects children under 5 years old. The document traces typhoid fever back to its first descriptions in the 2nd century AD. It provides statistics on the disease's worldwide prevalence and mortality. Symptoms are described as generally including fever, headache, abdominal pain and distension. Treatment has traditionally involved antibiotics like ciprofloxacin, though drug resistance is a problem. The document advocates for single daily doses of ceftriaxone via syringe rather than IV to reduce costs and drug-related fever in patients.

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    Typhoid Fever in Children: A Hospital Based Follow-Up: Department of Child Health

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    yustirahayu
    77 views20 pages
    Typhoid Fever in Children: a hospital based follow-up discusses the history and current state of typhoid fever, which primarily affects children under 5 years old. The document traces typhoid fever back to its first descriptions in the 2nd century AD. It provides statistics on the disease's worldwide prevalence and mortality. Symptoms are described as generally including fever, headache, abdominal pain and distension. Treatment has traditionally involved antibiotics like ciprofloxacin, though drug resistance is a problem. The document advocates for single daily doses of ceftriaxone via syringe rather than IV to reduce costs and drug-related fever in patients.

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    Typhoid Fever in Children

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    Typhoid Fever in Children: a hospital based follow-up discusses the history and current state of typhoid fever, which primarily affects children under 5 years old. The document traces typhoid fever back to its first descriptions in the 2nd century AD. It provides statistics on the disease's worldwide prevalence and mortality. Symptoms are described as generally including fever, headache, abdominal pain and distension. Treatment has traditionally involved antibiotics like ciprofloxacin, though drug resistance is a problem. The document advocates for single daily doses of ceftriaxone via syringe rather than IV to reduce costs and drug-related fever in patients.

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    77 views20 pages

    Typhoid Fever in Children: A Hospital Based Follow-Up: Department of Child Health

    Uploaded by

    yustirahayu
    Typhoid Fever in Children: a hospital based follow-up discusses the history and current state of typhoid fever, which primarily affects children under 5 years old. The document traces typhoid fever back to its first descriptions in the 2nd century AD. It provides statistics on the disease's worldwide prevalence and mortality. Symptoms are described as generally including fever, headache, abdominal pain and distension. Treatment has traditionally involved antibiotics like ciprofloxacin, though drug resistance is a problem. The document advocates for single daily doses of ceftriaxone via syringe rather than IV to reduce costs and drug-related fever in patients.

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    Typhoid Fever in Children: a hospital based follow-up

    Dr. Pushpa R Sharma Professor of Child Health

    Department of Child Health

    HISTORY

    OF

    THE

    TYPHOID

    FEVER

    Antonius Musa, a Roman physician who achieved fame by treating the Emperor Augustus 2,000 year ago, with cold baths when he fell ill with typhoid.

    Thomas Willis who is credited with the first description of typhoid fever in 1659.

    William Wood Gerhard who was the first to differentiate clearly between typhus fever and typhoid in 1837.

    Carl Joseph Eberth who discovered the typhoid bacillus in 1880.

    Georges Widal who described the Widal agglutination reaction of the blood in 1896.

    History
    In the mid-nineteenth century, Sir William Jenner undertook the first successful definition of typhoid, clearly delineating Typhoid bacilli in culture plate it from typhus, which is spread by lice and has The genus is named for differing symptoms. Karl J. the pathologist Erberth isolated the first Salmon, who first causal organism for typhoid isolated Salmonella fever in 1880, thus providing choleraesuis from porcine intestine. the basis for a definitive diagnosis.

    History (contd)
    The best known carrier was "Typhoid Mary"; Mary Mallon was a cook in Oyster Bay, New York in 1906 who is known to have infected 53 people, 5 of whom died. Five years after her release, she was found to have been the source of 25 cases of typhoid at the Women's Hospital in Manhattan.

    Epidemiology

    Typhoid and paratyphoid fevers are endemic in the Indian subcontinent. Typhoid fever affects 17 million people worldwide every year, with approximately 600,000 deaths. Case fatality rates of 10-50% children aged 1-5 years are at the highest risk The incubation period range 3-56 days.

    Typhoid fever strikes mostly children


    % of typhoid fever cases

    Mean age at KCH is 7.8 yrs (n=32): 2002


    25%

    20%
    15% 10% 5% 0% 0-4 '10-14 20-24 45-54 years of age

    Symptomatology (contd)
    Long and constraining clinical features
    Diarrhea Splenomegaly Toxic look Hepatomegaly Abdominal distension Crackles Long convalescence

    Headache Abdominal pain Cough Constipation, diarrhoea Asymptomatic 37C D3-56 D0 D7

    40C

    D21

    Incubation

    Invasion Status period Recovery

    Diseases do not follow the text book picture

    Symptoms (contd)
    Symptoms
    Fever
    Typhoid fever (%) KCH 2002 (n=32) Paratyphoid A & B (%)

    89-100

    100%

    92-100

    Headache Nausea Vomiting Abdominal pain Distension Diarrhoea Constipation

    43-90 23-36 24-35 8-52


    30-57 10-79

    32%
    3.1%

    60-100 33-58 22-45 29-92

    21.8% 25% 17-68 9.3% 2-29

    Total leukocytes count (n=32)

    <4000 4000-6000 6000-8000 8000-10000 >10000

    Total counts are not helpful

    Pattern of antibiotics being used n=32


    Cefixime Cephal Oflo Chloro Cipro 0 5 10 15 20 Bar 1

    Antibiotic Sensitivity
    100 90 80 70 60 50 40 30 20 10 0 Ciprofloxacin Cefotaxime Norfloxacin Chloramphenic ol Cotrimoxazole Amoxycilline

    Approach to a child with fever


    A child with fever without any localizing signs
    Fever in the first week without treatment Fever in the first week with antibiotics Fever in the second week with various antibiotics

    Observe for the general condition, look for the specific signs Work-up for investigations, counsel the parents

    Treatment (contd)

    Temperature subsides when drugs are withheld

    Problem with i.v. ceftriaxone Drug fever Cost

    Single daily dose by syringe for three days only. 1 Reduces the cost and fever

    m J Trop Med Hyg., 52(2), 1995. 162-165.

    Ceftriaxone fever in Typhoid

    through i.v drip

    Through syringe

    Thank you

    Thank you

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