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TYPHOID FEVER

DESCRIPTION

Typhoid fever is a bacterial infection of the gastrointestinal tract. Body parts involved include the gastrointestinal tract, the skin and the central nervous system--including the brain, the coverings of the brain (meninges), and the spinal cord -- and peripheral nerves. Typhoid fever can affect both sexes, all ages, but infants can have especially severe cases.
Appropriate health care includes:
  • Physician's monitoring of general condition and medications.
  • Self-care during the convalescent stage.
  • Hospitalization for severe cases.

    SIGNS & SYMPTOMS

  • Diarrhea. In mild cases, this may be only 2 or 3 loose bowel movements a day. In severe cases, it may be watery diarrhea as often as every 10 or 15 minutes.
  • Vomiting.
  • Fever.
  • Headache.
  • Muscle aches.
  • Skin rash on the child's abdomen.
  • Abdominal cramps (sometimes).
  • Blood in the child's stool (sometimes). A relatively mild attack may be mistaken for simple gastroenteritis.

    CAUSES

  • Infection with the salmonella typhi bacteria. The bacteria is found in infected animals and transmitted to children (or adults) in contaminated meat or milk. Thorough cooking kills the germ.
  • The infection can also be transmitted by ill persons or non-ill carriers who handle food without careful hand-washing after bowel movements.

    RISK FACTORS

  • Illness that has lowered your child's resistance.
  • Crowded or unsanitary living conditions.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Your child should follow these recommendations in any area with a substandard water supply: -- Drink purified water, boil water, or add 2 to 4 drops of 4% to 6% chlorine bleach to each quart of water 30 minutes before use. -- If in a hotel, draw hot water from the faucet, let it cool and use it as drinking water. -- Don't use ice. -- Don't eat raw fruits and vegetables unless you can peel them.
  • Drink only pasteurized milk.
  • Wash your hands after bowel movements and before handling food.
  • Obtain a vaccination if exposed to typhoid.

    BASIC INFORMATION

    MEDICAL TESTS

    Your own observation of symptoms; medical history and physical exam by a doctor; laboratory studies, such as stool studies and a blood culture; X-rays of the child's gastrointestinal tract; sigmoidoscopy (See Glossary).

    POSSIBLE COMPLICATIONS

    Dehydration; perforation of the child's intestines; gastrointestinal hemorrhage or abscess; deep-vein blood clot; pneumonia; bone infection; congestive heart failure.

    PROBABLE OUTCOME
    Usually curable in 2 to 3 weeks with treatment. Without treatment, it can be fatal to your child.

    TREATMENT

    HOME CARE

  • Isolate ill children and have them use bedside commodes or a separate bathroom; use a heating pad or hot-water bottle to relieve the child's abdominal cramps.
  • Wash hands carefully and often while treating the child; turn the child frequently in bed.
  • Apply lukewarm wet towels to the child's groin and underarms to reduce fever. Don't use aspirin or acetaminophen; both irritate the gastrointestinal tract.

    MEDICATION
    Your doctor may prescribe antibiotics, such as ampicillin or sulfa drugs.

    ACTIVITY
    Bed rest is necessary for your child until all symptoms have been gone at least 3 days. The child's legs should be flexed often in bed to prevent formation of deep-vein blood clots.

    DIET & FLUIDS
    A clear-liquid diet is necessary during the diarrhea phase. Later, a high-calorie, well-balanced diet is necessary. In addition, vitamin and mineral supplements may be helpful to your child.

    OK TO GO TO SCHOOL?

    When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of typhoid fever.
  • The following occurs during treatment: fever of 102F (38.9C) or higher; sore throat; severe cough or coughing up blood; shortness of breath; severe abdominal pain or swelling; rectal bleeding; pain in the child's calf or leg; headache, earache, or swollen joints. ‡
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