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Paratyphoid fever resembles typhoid fever. Infection is characterized by a sustained fever, headache, abdominal pain, malaise, anorexia, a nonproductive cough (in early stage of illness), a relative bradycardia (slow heart rate), and hepatosplenomegaly (an enlargement of the liver and spleen). About 30% of Caucasians develop rosy spots on the central body. In adults, constipation is more common than diarrhea.
Only 20% to 40% of people initially have abdominal pain. Nonspecific symptoms such as chills, sweating, headache, loss of appetite, cough, weakness, sore throat, dizziness, and muscle pains are frequently present before the onset of fever. Some very rare symptoms are psychosis (mental disorder), confusion, and seizures.
Classically, the course 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.
- 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" Typhi or "S. paratyphi". The Widal test is usually negative in the first week.
- In the second week, the person is often too tired to get up, with high fever in plateau around and bradycardia (sphygmothermic dissociation or Faget sign), classically with a dicrotic pulse wave. Delirium is frequent, often calm, but sometimes agitated. This delirium gives to typhoid the nickname of "nervous fever". Rose spots appear on the lower chest and abdomen in around a third of patients. Rhonchi are heard in lung bases.
- The abdomen is distended and painful in the right lower quadrant, where borborygmi can be heard. Diarrhea can occur in this stage: six to eight stools in a day, green, comparable to pea soup, with a characteristic smell. However, constipation is also frequent. 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
Paratyphoid fever, also known simply as paratyphoid, is a bacterial infection caused by one of the three types of "Salmonella enterica". Symptoms usually begin six to thirty days after exposure and are the same as those of typhoid fever. Often there is a gradual onset of a high fever over several days. Weakness, loss of appetite, and headaches also commonly occur. Some people develop a skin rash with rose colored spots. Without treatment symptoms may last weeks or months. Other people may carry the bacteria without being affected; however, are still able to spread the disease to others. Both typhoid and paratyphoid are of similar severity. Paratyphoid fever is a type of enteric fever along with typhoid fever.
Paratyphoid is caused by the bacteria "Salmonella enterica" of the serotype Paratyphi A, Paratyphi B or Paratyphi C growing in the intestines and blood. They are usually spread by eating or drinking food or water contaminated with the feces of an infected person. They may occur when a person who prepares food is infected. Risk factors include poor sanitation as is found among poor crowded populations. Occasionally they may be transmitted by sex. Humans are the only animal infected. Diagnosis may be based on symptoms and confirmed by either culturing the bacteria or detecting the bacteria's DNA in the blood, stool, or bone marrow. Culturing the bacteria can be difficult. Bone marrow testing is the most accurate. Symptoms are similar to that of many other infectious diseases. Typhus is an unrelated disease.
While there is no vaccine specifically for paratyphoid, the typhoid vaccine may provide some benefit. Prevention includes drinking clean water, better sanitation, and better handwashing. Treatment of the disease is with antibiotics such as azithromycin. Resistance to a number of other previously effective antibiotics is common.
Paratyphoid affects about 6 million people a year. It is most common in parts of Asia and rare in the developed world. Most cases are due to Paratyphi A rather than Paratyphi B or C. In 2015 paratyphoid fever resulted in about 29,200 deaths down from 63,000 deaths in 1990. The risk of death is between 10% and 15% without treatment while with treatment it may be less than one percent.
Signs and symptoms include fever, headache, muscle pain, cough, and gastrointestinal symptoms. More virulent strains of "O. tsutsugamushi" can cause hemorrhaging and intravascular coagulation. Morbilliform rash, eschar, splenomegaly, and lymphadenopathies are typical signs. Leukopenia and abnormal liver function tests are commonly seen in the early phase of the illness. Pneumonitis, encephalitis, and myocarditis occur in the late phase of illness.
Acute scrub typhus appears to improve viral loads in patients with HIV. This interaction is challenged by an "in vitro" study.
Typhoid fever, also known simply as typhoid, is a bacterial infection due to "Salmonella" typhi that causes symptoms. Symptoms may vary from mild to severe and usually begin six to thirty days after exposure. Often there is a gradual onset of a high fever over several days. Weakness, abdominal pain, constipation, and headaches also commonly occur. Diarrhea is uncommon and vomiting is not usually severe. Some people develop a skin rash with rose colored spots. In severe cases there may be confusion. Without treatment, symptoms may last weeks or months. Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others. Typhoid fever is a type of enteric fever along with paratyphoid fever.
The cause is the bacterium "Salmonella" typhi, also known as "Salmonella enterica" serotype Typhi, growing in the intestines and blood. Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person. Risk factors include poor sanitation and poor hygiene. Those who travel to the developing world are also at risk and only humans can be infected. Diagnosis is by either culturing the bacteria or detecting the bacterium's DNA in the blood, stool, or bone marrow. Culturing the bacterium can be difficult. Bone marrow testing is the most accurate. Symptoms are similar to that of many other infectious diseases. Typhus is a different disease.
A typhoid vaccine can prevent about 30% to 70% of cases during the first two years. The vaccine may have some effect for up to seven years. It is recommended for those at high risk or people traveling to areas where the disease is common. Other efforts to prevent the disease include providing clean drinking water, better sanitation, and better handwashing. Until it has been confirmed that an individual's infection is cleared, the individual should not prepare food for others. Treatment of disease is with antibiotics such as azithromycin, fluoroquinolones or third generation cephalosporins. Resistance to these antibiotics has been developing, which has made treatment of the disease more difficult.
In 2015, there were 12.5 million new cases worldwide. The disease is most common in India. Children are most commonly affected. 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. Each year in the United States, about 400 cases are reported and it is estimated that the disease occurs in about 6,000 people. In 2015, it resulted in about 149,000 deaths worldwide – down from 181,000 in 1990 (about 0.3% of the global total). The risk of death may be as high as 20% without treatment. With treatment, it is between 1 and 4%. The name typhoid means "resembling typhus" due to the similarity in symptoms.
After a short incubation period of a few hours to one day, the bacteria multiply in the intestinal lumen, causing an intestinal inflammation. Most people with salmonellosis develop diarrhea, fever, vomiting, and abdominal cramps 12 to 72 hours after infection. Diarrhea is often mucopurulent (containing mucus or pus) and bloody. In most cases, the illness lasts four to seven days, and most people recover without treatment. In some cases, though, the diarrhea may be so severe that the patient becomes dangerously dehydrated and must be taken to a hospital. At the hospital, the patient may receive intravenous fluids to treat the dehydration, and may be given medications to provide symptomatic relief, such as fever reduction. In severe cases, the "Salmonella" infection may spread from the intestines to the blood stream, and then to other body sites, and can cause death, unless the person is treated promptly with antibiotics.
In otherwise healthy adults, the symptoms can be mild. Normally, no sepsis occurs, but it can occur exceptionally as a complication in the immunocompromised. However, in people at risk such as infants, small children, and the elderly, "Salmonella" infections can become very serious, leading to complications. In infants, dehydration can cause a state of severe toxicity. Extraintestinal localizations are possible, especially "Salmonella" meningitis in children, osteitis, etc. Children with sickle-cell anemia who are infected with "Salmonella" may develop osteomyelitis. Treatment of osteomyelitis, in this case, will be to use fluoroquinolones (ciprofloxacin, levofloxacin, etc., and nalidixic acid).
Those whose only symptom is diarrhea usually completely recover, but their bowel habits may not return to normal for several months.
Salmonellosis is a symptomatic infection caused by bacteria of the "Salmonella" type. The most common symptoms are diarrhea, fever, abdominal cramps, and vomiting. This typically occurs half to three days after exposure with symptoms lasting four to seven days. Occasionally more significant disease can result in dehydration. The old, young, and others with a weak immune systems are more likely to develop severe disease. Specific types of "Salmonella" can result in typhoid fever or paratyphoid fever.
There are two species of "Salmonella": "Salmonella bongori" and "Salmonella enterica" with many subtypes. Infection is usually spread via contaminated meat, eggs, or milk. Other foods may spread the disease if they have come into contact with manure. A number of pets may also carry the infection and spread the infection including, cats, dogs, and reptiles. Diagnosis is by a stool test.
Efforts to prevent the disease include proper preparation and cooking of food. Mild disease typically does not require specific treatment. More significant cases may need the treatment of electrolyte problems and the replacement of fluids by intravenous. In those at high risk or in whom the disease has spread outside the intestines, antibiotics are recommended.
Salmonellosis is one of the most common causes of diarrhea globally. In 2015, 90,300 deaths occurred from non-typhoidal and 178,000 deaths from typhoidal salmonellosis. In the United States about 1.2 million cases and 450 deaths occur from non–typhoidal salmonellosis a year. In Europe it is the second most common foodborne disease after campylobacteriosis.
Scrub typhus or bush typhus is a form of typhus caused by the intracellular parasite "Orientia tsutsugamushi", a Gram-negative α-proteobacterium of family Rickettsiaceae first isolated and identified in 1930 in Japan.
Although the disease is similar in presentation to other forms of typhus, its pathogen is no longer included in genus "Rickettsia" with the typhus bacteria proper, but in "Orientia". The disease is thus frequently classified separately from the other typhi.
Intestinal infectious diseases include a large number of infections of the bowels including: cholera, typhoid fever, paratyphoid fever, other types of salmonella infections, shigellosis, botulism, gastroenteritis, and amoebiasis among others.
Typhoid and paratyphoid resulted in 221,000 deaths in 2013 down from 259,000 deaths in 1990. Other diseases which result in diarrhea caused another 1.3 million additional deaths in 2013 down from 2.6 million deaths in 1990.
The most common presentation is a single large, deep ulcer (although several smaller ulcers may occur) in the internal surface of one or both labia minora. The labia majora may be affected, as may the vagina and urethra. The ulcer develops very quickly, and is usually preceded by sudden onset of fever and malaise.
Lipschütz ulcer, ulcus vulvae acutum or reactive non-sexually related acute genital ulcers () is a rare disease characterized by painful genital ulcers, fever, and lymphadenopathy, occurring most commonly, but not exclusively, in adolescents and young women. Previously, it was described as being more common in virgins. It is not a sexually transmitted disease, and is often misdiagnosed, sometimes as a symptom of Behçet's disease.
Lipschütz ulcer is named after Benjamin Lipschütz, who first described it in 1912. The cause is still unknown, although it has been associated with several infectious causes, including paratyphoid fever, cytomegalovirus, "Mycoplasma pneumoniae" and Epstein-Barr virus infection