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Верзија на датум 6. мај 2019. у 05:19

Не поистовећивати са Tifus.
Tifoidna groznica
SinonimiSpora groznica, tifoid
Rose spots on the chest of a person with typhoid fever
SpecijalnostiInfectious disease
SimptomiFever, abdominal pain, headache, rash[1]
Vreme pojave6–30 days after exposure[1][2]
UzrociSalmonella enterica subsp. enterica (spread by food or water contaminated with feces)[3][4]
Faktori rizikaPoor sanitation, poor hygiene.[3]
Dijagnostički metodBacterial culture, DNA detection[2][3][5]
Slična oboljenjaOther infectious diseases[6]
PrevencijaTyphoid vaccine, handwashing[2][7]
LečenjeAntibiotici[3]
Frekvencija12,5 miliona (2015)[8]
Smrtnost149,000 (2015)[9]

Tifoidna groznica, takođe jednostavno poznata kao tifoid, je bakterijska infekcija uzrokovana specifičnim tipom Salmonella koja uzrokuje simptome tifusa.[3] Simptomi mogu da variraju od veoma blagih do jakih i obično se javljaju šest to trideste dana nakon izlaganja.[1][2] Often there is a gradual onset of a high fever over several days.[1] This is commonly accompanied by weakness, abdominal pain, constipation, headaches, and mild vomiting.[2][6] Some people develop a skin rash with rose colored spots.[2] In severe cases people may experience confusion.[6] Without treatment, symptoms may last weeks or months.[2] Diarrhea is uncommon.[6] Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others.[4] Typhoid fever is a type of enteric fever, along with paratyphoid fever.[3]

The cause is the bacterium Salmonella enterica subsp. enterica growing in the intestines and blood.[2][6] Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person.[4] Risk factors include poor sanitation and poor hygiene.[3] Those who travel in the developing world are also at risk.[6] Only humans can be infected.[4] Symptoms are similar to those of many other infectious diseases.[6] Diagnosis is by either culturing the bacteria or detecting the bacterium's DNA in the blood, stool, or bone marrow.[2][3][5] Culturing the bacterium can be difficult.[10] Bone marrow testing is the most accurate.[5]

A typhoid vaccine can prevent about 40% to 90% of cases during the first two years.[7] The vaccine may have some effect for up to seven years.[3] It is recommended for those at high risk or people traveling to areas where the disease is common.[4] Other efforts to prevent the disease include providing clean drinking water, good sanitation, and handwashing.[2][4] Until it has been confirmed that an individual's infection is cleared, the individual should not prepare food for others.[2] The disease is treated with antibiotics such as azithromycin, fluoroquinolones or third generation cephalosporins.[3] Resistance to these antibiotics has been developing, which has made treatment of the disease more difficult.[3][11]

In 2015, there were 12.5 million new cases worldwide.[8] The disease is most common in India.[3] Children are most commonly affected.[3][4] Rates of disease decreased in the developed world in the 1940s as a result of improved sanitation and use of antibiotics to treat the disease.[4] Each year in the United States, about 400 cases are reported and it is estimated that the disease occurs in about 6,000 people.[6][12] In 2015, it resulted in about 149,000 deaths worldwide – down from 181,000 in 1990 (about 0.3% of the global total).[9][13] The risk of death may be as high as 20% without treatment.[4] With treatment, it is between 1 and 4%.[3][4] Typhus is a different disease.[14] However, the name typhoid means "resembling typhus" due to the similarity in symptoms.[15]

Video summary (script)

Signs and symptoms

Rose spots on chest of a person with typhoid fever

Classically, the progression of untreated typhoid fever is divided into four distinct stages, each lasting about a week. Over the course of these stages, the patient becomes exhausted and emaciated.[16]

  • In the first week, the body temperature rises slowly, and fever fluctuations are seen with relative bradycardia (Faget sign), malaise, headache, and cough. A bloody nose (epistaxis) is seen in a quarter of cases, and abdominal pain is also possible. A decrease in the number of circulating white blood cells (leukopenia) occurs with eosinopenia and relative lymphocytosis; blood cultures are positive for Salmonella enterica subsp. enterica or S. paratyphi. The Widal test is usually negative in the first week.[17]
  • In the second week, the person is often too tired to get up, with high fever in plateau around 40 °C (104 °F) and bradycardia (sphygmothermic dissociation or Faget sign), classically with a dicrotic pulse wave. Delirium can occur, where the patient is often calm, but sometimes becomes agitated. This delirium has lead to typhoid receiving the nickname "nervous fever". Rose spots appear on the lower chest and abdomen in around a third of patients. Rhonchi (rattling breathing sounds) are heard in the base of the lungs. The abdomen is distended and painful in the right lower quadrant, where a rumbling sound can be heard. Diarrhea can occur in this stage, however constipation is also common. The spleen and liver are enlarged (hepatosplenomegaly) and tender, and liver transaminases are elevated. The Widal test is strongly positive, with antiO and antiH antibodies. Blood cultures are sometimes still positive at this stage. The major symptom of this fever is that the fever usually rises in the afternoon up to the first and second week.
  • In the third week of typhoid fever, a number of complications can occur:
    • Intestinal haemorrhage due to bleeding in congested Peyer's patches; this can be very serious, but is usually not fatal.
    • Intestinal perforation in the distal ileum: this is a very serious complication and is frequently fatal. It may occur without alarming symptoms until septicaemia or diffuse peritonitis sets in.
    • Encephalitis
    • Respiratory diseases such as pneumonia and acute bronchitis
    • Neuropsychiatric symptoms (described as "muttering delirium" or "coma vigil"), with picking at bedclothes or imaginary objects.
    • Metastatic abscesses, cholecystitis, endocarditis, and osteitis
    • The fever is still very high and oscillates very little over 24 hours. Dehydration ensues, and the patient is delirious (typhoid state). One-third of affected individuals develop a macular rash on the trunk.
    • Platelet count goes down slowly and risk of bleeding rises.
  • By the end of third week, the fever starts subsiding.

Reference

  1. ^ а б в г Anna E. Newton (2014). „3 Infectious Diseases Related To Travel”. CDC health information for international travel 2014 : the yellow book. ISBN 9780199948499. Архивирано из оригинала 2015-07-02. г. 
  2. ^ а б в г д ђ е ж з и ј „Typhoid Fever”. cdc.gov. 14. 5. 2013. Архивирано из оригинала 6. 6. 2016. г. Приступљено 28. 3. 2015. 
  3. ^ а б в г д ђ е ж з и ј к л љ Wain, J; Hendriksen, RS; Mikoleit, ML; Keddy, KH; Ochiai, RL (21. 3. 2015). „Typhoid fever”. Lancet. 385 (9973): 1136—45. PMID 25458731. doi:10.1016/s0140-6736(13)62708-7. 
  4. ^ а б в г д ђ е ж з и „Typhoid vaccines: WHO position paper” (PDF). Wkly Epidemiol Rec. 83 (6): 49—59. 8. 2. 2008. PMID 18260212. Архивирано (PDF) из оригинала 2. 4. 2015. г. 
  5. ^ а б в Crump, JA; Mintz, ED (15. 1. 2010). „Global trends in typhoid and paratyphoid Fever”. Clin Infect Dis. 50 (2): 241—6. PMC 2798017 Слободан приступ. PMID 20014951. doi:10.1086/649541. 
  6. ^ а б в г д ђ е ж „Typhoid Fever”. cdc.gov. 14. 5. 2013. Архивирано из оригинала 2. 4. 2015. г. Приступљено 28. 3. 2015. 
  7. ^ а б Milligan, R; Paul, M; Richardson, M; Neuberger, A (31. 5. 2018). „Vaccines for preventing typhoid fever”. The Cochrane Database of Systematic Reviews. 5: CD001261. PMID 29851031. doi:10.1002/14651858.CD001261.pub4. 
  8. ^ а б GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8. 10. 2016). „Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015”. Lancet. 388 (10053): 1545—1602. PMC 5055577 Слободан приступ. PMID 27733282. doi:10.1016/S0140-6736(16)31678-6. 
  9. ^ а б GBD 2015 Mortality and Causes of Death, Collaborators. (8. 10. 2016). „Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015”. Lancet. 388 (10053): 1459—1544. PMC 5388903 Слободан приступ. PMID 27733281. doi:10.1016/s0140-6736(16)31012-1. 
  10. ^ Alan J. Magill (2013). Hunter's tropical medicine and emerging infectious diseases (9th изд.). London: Saunders/Elsevier. стр. 568—572. ISBN 9781455740437. Архивирано из оригинала 2017-02-28. г. 
  11. ^ Chatham-Stephens, K; Medalla, F; Hughes, M; Appiah, GD; Aubert, RD; Caidi, H; Angelo, KM; Walker, AT; Hatley, N; Masani, S; Nash, J; Belko, J; Ryan, ET; Mintz, E; Friedman, CR (11. 1. 2019). „Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan - United States, 2016-2018.”. MMWR. Morbidity and Mortality Weekly Report. 68 (1): 11—13. PMID 30629573. doi:10.15585/mmwr.mm6801a3. 
  12. ^ Jackson, BR; Iqbal, S; Mahon, B (27. 3. 2015). „Updated Recommendations for the Use of Typhoid Vaccine – Advisory Committee on Immunization Practices, United States, 2015”. Morb Mortal Wkly Rep. 64 (11): 305—308. PMC 4584884 Слободан приступ. PMID 25811680. 
  13. ^ GBD 2013 Mortality and Causes of Death, Collaborators (17. 12. 2014). „Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013”. Lancet. 385 (9963): 117—71. PMC 4340604 Слободан приступ. PMID 25530442. doi:10.1016/S0140-6736(14)61682-2. 
  14. ^ Cunha BA (март 2004). „Osler on typhoid fever: differentiating typhoid from typhus and malaria”. Infect Dis Clin N Am. 18 (1): 111—25. PMID 15081508. doi:10.1016/S0891-5520(03)00094-1. 
  15. ^ „Oxford English Dictionary (Online)”. стр. typhoid, adj. and n. Архивирано из оригинала 11. 1. 2008. г. Приступљено 28. 3. 2015. „Resembling or characteristic of typhus” 
  16. ^ „Typhoid”. Merriam Webster Dictionary. Архивирано из оригинала 2013-07-02. г. Приступљено 2013-06-24. 
  17. ^ Kumar P, Kumar R (2016). „Enteric Fever”. Indian J Pediatr. 84 (3): 227—230. PMID 27796818. doi:10.1007/s12098-016-2246-4. 

Literatura

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