fever (39°C – 40°C) without symptoms of cold and cough, but with headache, loss of
appetite, dullness, constipation, coated tongue, and
delirium points towards typhoid. History of contact with a
patient having typhoid at home further adds to the suspicion.
Some patients may feel chilly and have a slight cough. The
abdomen may be slightly bloated. Later in the disease, the child
may develop loose motions. Your doctor will take note of the
above features and would find an enlarged liver and spleen
towards the end of the week.
Confirmation Of Diagnosis And Treatment
No antibiotic should be given before collecting a blood
sample for culture. The hospital laboratory should be requested
to observe the culture for one week as the organism may sometimes take time to grow. In case of a strong
suspicion, your doctor may decide to start the appropriate
antibiotic while waiting for the report. It may take 6 to 7 days before
response to the antibiotics is noticed. If the blood grows
typhoid organisms, the laboratory will test for the drugs to
which the organisms are most sensitive. Then your doctor may
decide to continue the same medicine or change over to a new one
that may also take a couple of days to show a positive
Before the culture report comes, a total white blood
cell count of less than 4000/mm.3 may also be
supportive of the diagnosis of typhoid. Another test commonly asked for is
the Widal test. This becomes positive in the second week,
but the result of this test loses its reliability if the
antibiotics have been started too early in the course of the disease.
Paracetamol may be given for symptomatic relief of fever and headache. Sponging of the
body with warm water can
be done for lowering the temperature.
PREVENTION: The source of
infection is contaminated water, ice, food (including canned foods) and milk. The
patient continues to pass the germs of the illness in the stools
for upto 3 months afterwards. Proper hand washing is
essential. Water must be boiled and cooled before being consumed. Do not listen to those who say that on some occasion you
may have to take unboiled water outside, and so it is
useless to take boiled water at home. You must note that a large
number of typhoid germs would need to be swallowed to start the disease process. So we should always aim at cutting down
the bacterial load as much as possible.
Read the chapter on IMMUNISATION for vaccination against typhoid.
7 March, 2016