Paratyphoid

  • Paratyphoid in children
  • Paratyphoid is an acute infectious diseases by clinical, pathogenesis and epidemiological characteristics similar to typhoid fever.
    Etiology. Pathogens paratyphoid are three serological types of germs of the genus Salmonella (S. paratyphi A, S. paratyphi In and S. paratyphi), morphologically similar to typhoid bacteria.
    Epidemiology, pathogenesis and pathanatomy - see typhoid fever.
    The clinical picture. The clinical picture paratyphoid And usually corresponds to the clinical manifestations of typhoid. You can, however, identify a number of peculiarities of clinical course of these diseases.
    When paratyphoid And onset often acute, often with catarrhal phenomena: cough, runny nose, sore throat. Quite often there is a vascular injection sclera, zoster, laryngitis, bronchitis. The disease is accompanied by chills, then. The temperature in most cases, high, usually of the wrong type.
    The duration of febrile period of 3-4 days to 3-4 weeks.
    From the 3rd day of illness appear variety rash-roseolous, crepadona, often pesciatina. Possible re rash. Language dry. The mucous membrane of the mouth, nose hyperemic. Can be nosebleeds. He has no appetite. Belly swollen, at a palpation painful in the right iliac region. Kal more liquid, without visible pathological admixtures. The liver is enlarged and often painful. The spleen also increased. Blood pressure is reduced. Pulse Ochsen. The heart sounds are muffled. Typhoid status is expressed only in severe disease.
    Complications at paratyphoid And observed the same as when typhoid fever, but much less: intestinal bleeding and perforation of the intestinal ulcers, cholecystitis, pneumonia, pielity, myocarditis, thrombophlebitis and other Recurrent disease are short and are light.
    Paratyphoid In the clinical course often reminds bruchnotifozna disease, but in some cases, the clinical picture is significantly different from the classical course of typhoid fever.
    Beginning of the disease is acute. Appears thirst, nausea, vomiting, diarrhea (cal liquid, smelly), pain around the abdomen or in the epigastric region, severe headaches Belle, insomnia, weakness. The temperature will rapidly reach high numbers, and kept at a high level from 5 to 20 days, falling more political. On 4-6th day of illness appear rich rash with large elements on the skin of the trunk, limbs and face. Language dry. The liver and spleen were enlarged. Changes in the cardiovascular system are the same as with typhoid fever: aetiology, the deaf heart sounds, hypotension. Possible effects of bronchitis or pneumonia. Usually paratyphoid In proceeds easier than typhoid fever, but there is also a severe course with septic manifestations in the form of purulent meningitis, meningoencephalitis and septicopyemia.
    Changes of blood atypical: possible leucocytosis or lakopenia; often defined eosinophilia.
    Paratyphoid With (N) to the clinical course is intermediate between typhoid fever and clinic of Salmonella. The disease may be in the form of different clinical forms: gastroenteriticheskaya, typhoid, septic and other
    Gastroenteriticheskaya form begins acutely with chills, fever to high numbers. Appear nausea, vomiting, diarrhea, abdominal pain and rumbling. Language dry. Enlarged liver and spleen. Typhoid status is not defined. Significant changes are observed on the part of the cardiovascular system: tachycardia, deaf heart sounds, sudden drop in blood pressure and even collapse. The duration of the disease from several hours to several days.
    In blood there is an increasing number of erythrocytes and hemoglobin due to fluid loss and thickening of the blood, leukocytosis with a sharp stab shift to the left.
    Typhoid form the clinical course is similar to Brusnitsyn disease, but in some cases, the clinical picture is different from the flow of typhoid fever.
    Onset often acute, there chills, sweats, body aches, and sometimes pain in the joints, a tendency to constipation. The liver and spleen were enlarged. Typhoid status pronounced blurred.
    The disease is more benign than with typhoid fever.
    Septic form paratyphoid With proceeds by type of sepsis with incorrect or remitting type of fever, chills, then. Often develop septic foci in various organs. Leather with yellowish shade.
    Laboratory diagnostics. The main method of diagnosis is the allocation hemo-bacteria cultures paratyphoid a, b and C. If you suspect protivoskol infection in any day febrile period produce a crop of blood and faeces, urine and bile.
    When gastroenteriticheskaya form paratyphoid With recommended sowing vomit. You can apply fluorescent-serological method of research of blood.
    Reaction Vidal often negative or appears late in low titers, so it is recommended to use the haemagglutination reaction, which becomes positive with 5-6-th day of illness and is more specific.
    Treatment. Shows a strict bed rest, diet, good care for your mouth, rubbing the skin with camphor spirit, warm baths (in the absence of contraindications); the turning of the patient in bed.
    Appoint chloramphenicol scheme. Daily dose of the antibiotic prescribed for the paratyphoid a and b until the 2nd day of normal temperature is 2 g, from the 3rd to 7th day of normal temperature - 1.5 g and 8-th to 10-th day - 1,0 g
    Treatment paratyphoid To spend levomicetinom 2 g per day to reduce the temperature.
    Recommended combined antibacterial therapy and vaccine therapy.
    Apply cardiovascular drugs injected saline solutions, and also solutions of glucose.
    Forecast - see typhoid fever.
    Prevention paratyphoid fully corresponds to the preventive measures recommended for typhoid fever (see typhoid fever).

    Paratyphoid (paratyphus) is an acute infectious disease from a group of intestinal infections caused by representatives of the group partypany bacteria.