hi everyone this model is on typhoid fever in the mid year sort of what causes typhoid fever all snicker the pathogenesis signs and aftereffects assurance and therapy of typhoid fever so typhoid fever is achieved by a defilement with a gram-pessimistic microorganisms Salmonella enterica serovar typhi or basically key a sort ii or an associated microorganisms Salmonella parrot IV which has different subtypes a B or C both of these microorganisms cause hardly extraordinary clinical presentations yet we generally call pollutions by both of these typhoid fever,
there's furthermore the term we use digestive fever which portrays both the typhoid paratyphoid fever so we can use typhoid fever or gastrointestinal fever then again house typhoid fever conveyed well individuals are actually the only vault for this sort of microorganisms so it requirements to come from a human to another human so either might this anytime at any point can be through direct contact or underhanded contact through tarnished food or water now the bet factors for contracting typhoid fever integrate being a youngster or energetic adult children and young adults are more defenseless to typhoid fever one more is pressing so you can imagine if there's loads of people if anybody's debased they can without a very remarkable stretch impart it through prompt or circuitouscontact and lamentable sanitization is also another bet factor so again through spoiled food water if there's unfortunate sanitization regarding food or water it's easier to send this so the manner by which doesbSeminole at I cost and Seminole apéritif II pollutant us and make us crippled to cause typhoid fever well these microorganisms are ingested orally and they truly get through the gastricvacids and a while later go into the duodenum which is the underlying fragment of the little stomach related framework when they enter the duodenum they truly can penetrate through stomach related epithelium and assault intoblymphoid tissue and they do as such by a few novel instruments one is through an EM cell which is fundamental for the mucosal related lymphoid tissue system or mult structure and the second way that this organisms can truly invade into the epithelium is through direct entry into an epithelial cell through CFTR or cystic fibrosis transmembrane conductance regulator which is a chloride molecule channel so may be thinking cystic fibrosis transmembrane conductance regulator what does this mean well this is actually the chloride molecule direct that is changed in patients with cystic fibrosis so essentially what happens is the major kind your parrot IP use or catch this chloride molecule channel and use it to go into gastrointestinal epithelial cells so's especially entrancing that since this redirect is changed in patients with cystic fibrosis cystic fibrosis patients may truly be protected against typhoid less sicknesses or defilements by the organisms that cause typhoid fever so again incredibly captivating something different that happens is that the first kind II microorganisms once it goes into the epithelium will genuinely duplicate in the submucosa causing peyer's fix hypertrophy peyer's fix is lymphatic tissue in the processing plots that becomes hypertrophy because the microorganisms really increase s' inside to cause that hypertrophy and finally the tiny organic entities will scatter through the body by the lymphatic system and hematogenous lead through the blood to cause countless the secondary effects were discussed in the accompanying slide so the clinical demonstration of typhoid fever can be summed up by a fever and stomach torture yet more unequivocally with this tainting there's an incidental effect starting that occurs in around 5 to 21 days. after ingestion of the microorganisms when the aftereffects happen depends upon the age of the patient the strength of the patient the gastric causticity of the patient's stomach and the amount of animals that are ingested in the vital multi day stretch of sickness we have what we call a stepwise fever this is the essential secondary effect you will see stepwise fever is called that since we see an ever-evolving step like extension in fever so you'll see a temperature it'll knock up to a more huge level and it will Level and a short time later it'll knock dependent upon another raised endlessly level at that so that is the explanation we call it stepwise in the second multi day stretch of pollution this is the place where we see the stomach distress and we in like manner see what we call rose spots line spots are little commonly one to five millimeters in size Blanche fit papules so you will see these on the skin of a defiled individual there Blanche fiascos so that genuinely expects that if you truly push on them they will evaporate anyway, will return so those are what we call it rose spots and in the third week you will see a piece of the disintegrating secondary effects you will see stomach related depleting so you could see hematochezia Molina you'revalso going to get a paddle splenomegaly so an expanding of the liver and the spleen and you can in like manner see gastrointestinal opening so fundamentally taking into account all that increasing minute organic entities inside the submucosa may truly cause a gastrointestinal opening different results of typhoid fever are a result of the GI system being affected so you can see free entrails or obstructing these seem to occur with comparable repeat so around half of the time you'll have the has with typhoid temperature the other portion of the time you'll have stoppage you can in like manner see headaches confounded rest models and you can in like manner get what we call typhoid encephalopathy typhoid encephalopathy causes a changed Mental Status disorder ludicrousness and, shockingly, extraordinary psychosis so how might we make the end and how would we treat typhoid fever examination of typhoid fever is through regularly thinking it anyway so you suspect the typhoid fever expecting there's receptiveness to an endemic locale and expecting you have been introduced to an area that has a lot of typhoid fever you will think it significantly more in the event that there's three days or more fever and GI secondary effects like the runs in the stoppage and the stomach torture we talked about or the hepatosplenomegaly or the gastrointestinal depleting and a short time later at whatever point you have figured it you can do a couple of tests you can do blood and stool social orders could do a bone marrow test yet that will not be something that you will do and a lot of times it might be an empiric assurance you will see the incidental effects you will see that they've been in an endemic district they'revnot vaccinated and a while later you will say you comprehend what this is undoubtedly a finding of typhoid fever and the therapy of typhoid fever depends upon adjacent deterrent plan so in specific region of the planet you will have different sorts of Salmonella typhi or perro forming there could be multi-drug resistance or MDR strains or even generally drug safe or XDR sorts of this microorganisms and that'svgonna change which neutralizing agent poison you will use, when in doubt, first line of counter agents poisons that you're going tovuse for typhoid fever consolidate fluoroquinolones azithromycin ceftriaxone or carbapenems in for outrageous infection you ought to add on a steroid like dexamethasone now various considerations of typhoid fever consolidate what we call lose the faith so a state of fall away from the faith all things considered happens around 50% of a month after objective of the fever so what happens is the symptoms of typhoid fever return after around 50% of a month following having objective of the fever so this is the very thing we call apostatize and this bet of break faith generally depends upon the counter disease that you used and again with the local resistance plans you will have to look out for which antibody poison depending upon the obstacle plans in that space another idea for typhoid fever integrates what we call steady carriage progressing carriage happens when you have a person that is had typhoid fever you given them right enemy of microbial they were managed they at absolutely no point in the future make side impacts or asymptomatic and it simply happens in two or three phenomenal individuals one to five percent of patients, when in doubt, what steady Harwich suggests is that they have been managed they're a consistent with life they're feeling improved at this point they are at this point releasing the animal regardless, for more than a year and that is generally the thing we call continuous carriage so they could be an extreme carrier that gets me truly releasing the natural element like the Seminole of Taif your parrot I cost even
following being managed at this point when they've are at this point releasing the animal essentially more than a year after the objective of the extraordinary infection we call that
continuous carriage so these people could essentially have this with them from now forward, endlessly a long time the bet factors for tenacious carriage
consolidate the going with integrates normally grown-up women biliary part affliction like having cholelithiasis so nerve stones the defense behind this is because the seminole
of tiny life forms hangs out in the nerve bladder so if there's any gallbladder stones in there they overall yield in and cause a biofilm on those nerve stones to stay there because the key organisms cause biofilms and stay inside the singular's nerve bladder the fundamental way we can get liberated
of them is truly to discard the nerve bladder so I'll call Asustek t'me is the treatment for tireless carriers
besides, another idea for typhoid fever is neutralization of typhoid fever regardless and this can occur through having new water disinfection and neatness review a lot of times this is sent from spoiled water.
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