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- 2. For diseases with the faeco-oral mechanism of transmission typically: - specific localization of the causative agent
- 3. Causative agent can constantly be in intestine (cholera, dysentery, some helminthic invasion) or temporarily, penetrate from
- 4. To intestinal infections, behind exception helminthic invasion the tendency to entire damage of the population is
- 5. Typhoid fever (Typhus abdominalis) and Paratyphoid A,B,C - typical disease with the faeco-oral mechanism of transmission.
- 6. Historic reference: From times Hippokrates (466 - 377 up to AD) to the18th century all diseases,
- 7. ETIOLOGY The causative agent of typhoid is Salmonella typhi ( S. ) of: family Enterobacteriacea, genus
- 9. S. can longly be survived in an organism as filtered or L- of the forms. S.
- 10. Salmonella typhi has 3 antigenes: - O- antigene (somatic, heat- stable) - Н-antigene (flagellar, heat- labile)
- 11. Epidemiology: typhoid fever is anthroponosis The source – sick the persons (20 – 30%) or the
- 12. Regions of earth with high risk infection by typhoid fever. Annually in the world are ill
- 13. Pathogeny: Typhoid fever has of next stages of a course of a infectious process: 1.Infection Infectious
- 14. 3. Part S. attack leucocytes, which start to work out prostaglandin Е, causing a secretory diarrhoea.
- 16. 6.The parenchymatous dissimination of S. (2 - 3 weeks of illness) It is characterized by a
- 17. - by cleaning in Peyer’s patches with derivation of ulcers, appearance of numerous necrosises of granulomas
- 18. Period of convalescence (5 - 6 weeks of illness) - normalization of microcirculation and restoration of
- 19. Pathomorphology - lymphatic nodes, liver, spleen, bone marrow are pletoric with the centers of a necrosis
- 20. Cliniccal manifestations The incubation interval of typhoid fever is useally 9 - 14 days but it
- 21. Objective: - Inhibited and adynamic, the paleness of a skin is (more often) or hyperemia of
- 22. Height of illness: 1st – 2nd weeks of illness - fever of a constant type Wunderlich
- 23. - excruciating headache and insomnia - « the typhous status » - sharp weakness, adynamia, insomnia,
- 26. - appearance for 55- 70 % of the patients with 8th - 10th days of illness
- 27. - skin acyanotic, dry, hot - the lips dry with scabs but herpes does not happen
- 28. - abdominal distention, meteorism, distinct s-m Падалки on the right - delay of a stool, but
- 29. Period of convalescence: 2 - 4 weeks. - step-by-step restoration organs of the lost functions and
- 30. The pneumotyphoid, colotyphoid, meningotyphoid - was installed earlier at predominance of a damage any of one
- 32. S. carriage - is taped for 3- 5 % convalescents, is more often for the persons
- 33. Ricketsioses malaria brucellosis listerosis atypical pneumonias sepsis miliary tuberculosis ornithosis lymphogranulomatosis pseudotuberculosis yersiniosis tularemia (pulmonary or
- 34. Laboratory diagnosis - diagnosis confirms by: - coprocytogram- leukocytosis (90 % from them monocytes) WBC –
- 35. - positive a urineculture – parallels the frequency coproculture - positive sputumculture - at clinic of
- 36. Treatment: - bed regimen (all feverish period + 5 - 10 days) - diet N 2
- 37. - alternative remedies:, ceftriaxone- 2 g/day ,ofloxacin- 800 mg/day, azitromicin-250-500-mg/day, cefoxim 400 mg/day and etc. Duration
- 38. Paratyphoid A –anthroponosis ( S. paratyphi A) - the incubation interval is reduced up to 8
- 39. plentiful, polymorphic exanthema with 4 - 7 days of illness
- 40. Paratyphoids B and C- zoonosis (animal and bird) S. schotmulleri, S. hirschfeldii - incubation 5 -
- 41. The rules of discharing of the infectious patient from a hospital for 21 days of normal
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