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    Dr. Rajesh Shah's advice on Typhoid

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Typhoid

Dr. Rajesh Shah, MD

Typhoid or Enteric fever is serious and common infection (in many countries) caused by the gram-negative bacilli Salmonella typhi and is characterized by sustained fever, abdominal pain, and a rash.

Causes

Contamination of food products and water supplies with infected fecal matter causes widespread infections. Flies can spread the infection directly from stool to foods. Typhoid is a water and food borne disease. Poor as well as developing countries such as Asian countries (India, Pakistan, Shri Lanka, Bangladesh), African countries have Enteric fever as a major health menace.

Symptoms

Gram-negative bacilli Salmonella typhiThe symptoms of typhoid fever start 7-14 days after consuming food or drinks contaminated with the Salmonella typhi bacteria. Untreated typhoid runs a course having four classical stages each lasting for about a week.

  • Fever with headache, malaise, relatively slow heart beats and cough.
  • There may be abdominal pain and episodes of bleeding from the nose.

Into the second week of untreated infection, symptoms seen are:

  • Fever hovers around 40°C (104°F) with relatively low pulse rate.
  • The abdomen seems bloated, distended and painful in the right lower quadrant. The bowel sounds are loud and audible.
  • Minute 'rose-colored' skin rash over the lower chest and upper abdomen, occur in nearly 50% of cases and last for 3 to 5 days.
  • The person may appear to be in a delirious state, constantly muttering to himself or picking at the bed-sheets.
  • Diarrhea may occur in this stage. Around 5 to 8 diarrheal stools, greenish, and looking like pea-soup are seen. However, constipation is more commonly seen.
  • Joint pains may be present.
  • The liver and spleen may seem enlarged.

The 3rd week of untreated typhoid can present with life-threatening emergencies:

  • Intestinal perforation ' perforation of the walls of small intestine can be life-threatening.
  • Bleeding into the intestines
  • Spread of the infection to the brain via the blood causing inflammation of the brain.
  • Inflammation of the gall-bladder, heart muscles; infections in the bones, and formation of abscesses within other important internal organs.

Diagnosis

Important changes seen in laboratory investigations are:

  • Complete Blood Count:
    In the first week of infection the blood counts will show
    • Reduction in the total number of white blood cells (leucopenia) and eosinophils
    • Increased number of and lymphocytes.
  • Blood Cultures: cultures come positive in the 1st and 2nd weeks of infection.
  • Widal Test: This test is negative in the 1st week and strongly positive from the 2nd week of infection.
  • Liver Function Tests: from the second week onwards, the liver transaminases appear to be elevated.

Treatment

Typhoid, timely treated, is rarely fatal. Vaccinations to prevent its occurrences and the use of broad spectrum antibiotics (chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin) have decreased the suffering in typhoid fever.

For person's who develop complications like perforation in the intestinal walls, surgical repair is indicated.

Homeopathy in enteric fevers

Homeopathy works for Enteric fever. We have documented several cases of successful cure of Enteric fever. However, the treatment is slower than the conventional antibiotics. We, at Life Force, do not recommend homeopathy for acute cases of Enteric fever.

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