Physical Examinations for Abdominal Typhus
Abdominal typhus is an acute infection that occurs in the small intestine.
Abdominal typhus is caused by salmonella typhi, Salmonella paratyphi A, Salmonella paratyphi B and Salmonella paratyphi C.
In typhoid endemic areas, the highest incidence in children. Adults often experience self-limiting infections and can become resistant. The incidence of 70-80% at age 12-30 years, 10 -2 -% at age 30-40 years, and 50-10% at age above 40 years, while the incidence of sex between men and women there was no difference is clear.
Physical Examinations for Abdominal Typhus
1) General State
Clients seem weak, increased body temperature 38-41 0 C, reddish face.
2) Level of Consciousness
Can a decline in consciousness (apathy).
3) Respiration System
Breathing average there is an increase, rapid breathing and in the description such as bronchitis.
4) Cardiovascular System
A decline in blood pressure, relative bradycardia, low hemoglobin.
5) Integumentary System
Dry skin, decreased skin turgor, pale face, dull hair
6) Gastrointestinal System
Dry chapped lips, dry oral mucosa, tongue dirty (typical), nausea, vomiting, anorexia, and constipation, abdominal pain, stomach feels uneasy, increased intestinal peristalsis.
7) Musculoskeletal System
The client is weak, felt tired but did not found any abnormalities.
8) Abdominal System
When palpation of the spleen and liver enlargement obtained with soft consistency and tenderness in the abdomen. Obtained on percussion and auscultation flatulence increased peristaltic gut.
9) Investigations
a) Examination of peripheral blood
Obtained by the presence of anemia due to limited food intake, impaired absorption occurs, inhibition of blood formation in the marrow and the destruction of red blood cells in blood circulation. Leukopenia with a leukocyte number between 3000 - 4000 / mm 3 was found in the phase of fever. This is caused by destruction of leucocytes by endotoxin. Aneosinofilia namely the loss of peripheral blood eosinophils. Thrombocytopenia occurs in the hot stage of the first week. Lymphocytosis is generally the number of lymphocytes increased due to endotoxin stimulation. Increased erythrocyte sedimentation rate.
b) Examination of urine
Found mild proteinuria (<2 g / liter) also found an increase in leucocytes in the urine.
c) Examination of stool
Found the presence of mucus and blood, suspicion of the dangers of bleeding and perforation of the intestine.
d) Examination of bacteriologic
Diagnosis must be upheld if found salmonella bacteria and fecal blood cultures, urine, bile or bone marrow.
e) Examination of serological
Namely agglutination reaction between antigen and antibody (aglutinin). The antibodies produced by the body due to salmonella bacteria infection is antibody O and H. If the O antibody titer was 1: 20 or more during the first week or occurred a progressive increase in antibody titer (more than 4 times). On cross examination 1 or 2 weeks later showed a positive diagnosis of infection with Salmonella typhi.
f) Examination of Radiology
This examination is to determine whether there are abnormalities or complications due to typhoid fever.
Abdominal typhus is caused by salmonella typhi, Salmonella paratyphi A, Salmonella paratyphi B and Salmonella paratyphi C.
In typhoid endemic areas, the highest incidence in children. Adults often experience self-limiting infections and can become resistant. The incidence of 70-80% at age 12-30 years, 10 -2 -% at age 30-40 years, and 50-10% at age above 40 years, while the incidence of sex between men and women there was no difference is clear.
Physical Examinations for Abdominal Typhus
1) General State
Clients seem weak, increased body temperature 38-41 0 C, reddish face.
2) Level of Consciousness
Can a decline in consciousness (apathy).
3) Respiration System
Breathing average there is an increase, rapid breathing and in the description such as bronchitis.
4) Cardiovascular System
A decline in blood pressure, relative bradycardia, low hemoglobin.
5) Integumentary System
Dry skin, decreased skin turgor, pale face, dull hair
6) Gastrointestinal System
Dry chapped lips, dry oral mucosa, tongue dirty (typical), nausea, vomiting, anorexia, and constipation, abdominal pain, stomach feels uneasy, increased intestinal peristalsis.
7) Musculoskeletal System
The client is weak, felt tired but did not found any abnormalities.
8) Abdominal System
When palpation of the spleen and liver enlargement obtained with soft consistency and tenderness in the abdomen. Obtained on percussion and auscultation flatulence increased peristaltic gut.
9) Investigations
a) Examination of peripheral blood
Obtained by the presence of anemia due to limited food intake, impaired absorption occurs, inhibition of blood formation in the marrow and the destruction of red blood cells in blood circulation. Leukopenia with a leukocyte number between 3000 - 4000 / mm 3 was found in the phase of fever. This is caused by destruction of leucocytes by endotoxin. Aneosinofilia namely the loss of peripheral blood eosinophils. Thrombocytopenia occurs in the hot stage of the first week. Lymphocytosis is generally the number of lymphocytes increased due to endotoxin stimulation. Increased erythrocyte sedimentation rate.
b) Examination of urine
Found mild proteinuria (<2 g / liter) also found an increase in leucocytes in the urine.
c) Examination of stool
Found the presence of mucus and blood, suspicion of the dangers of bleeding and perforation of the intestine.
d) Examination of bacteriologic
Diagnosis must be upheld if found salmonella bacteria and fecal blood cultures, urine, bile or bone marrow.
e) Examination of serological
Namely agglutination reaction between antigen and antibody (aglutinin). The antibodies produced by the body due to salmonella bacteria infection is antibody O and H. If the O antibody titer was 1: 20 or more during the first week or occurred a progressive increase in antibody titer (more than 4 times). On cross examination 1 or 2 weeks later showed a positive diagnosis of infection with Salmonella typhi.
f) Examination of Radiology
This examination is to determine whether there are abnormalities or complications due to typhoid fever.
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