Typhoid Fever

• A Clinical Overview
• Presented by: [Your Name]
• Course: BHMS
• Date: [Date]
 Introduction
• Typhoid fever is a life-threatening infection
caused by the bacterium *Salmonella
enterica* serotype Typhi.
• It is more common in areas where
handwashing is less frequent and water is not
clean.
• Characterized by prolonged fever, malaise,
abdominal pain, and constipation or diarrhea.
 Causative Organism
• *Salmonella typhi* is a Gram-negative, rod-
shaped bacterium.
• It possesses flagella for motility and survives
well in the intestinal tract.
• It has an endotoxin responsible for systemic
symptoms and a Vi antigen which helps evade
host immunity.
 Epidemiology
• Typhoid is endemic in parts of Asia, Africa, and
South America.
• Children and young adults are most commonly
affected.
• Incidence is linked to poor sanitation and
unsafe drinking water.
 Mode of Transmission
• Transmitted via the fecal-oral route, often due
to ingestion of contaminated food or water.
• Can also spread via direct contact with an
infected person or chronic carrier.
• Flies may transfer organisms from feces to
food.
 Pathogenesis
• After ingestion, bacteria pass through the
intestinal mucosa and are taken up by
macrophages.
• They multiply and disseminate through the
lymphatic and blood systems.
• Reinfection of intestinal tissues leads to
inflammation and ulceration.
 Clinical Features
• Symptoms progress in stages:
• Week 1: Fever, malaise, dry cough
• Week 2: High fever, abdominal distension,
rose spots
• Week 3: Intestinal complications, delirium
• Week 4: Gradual improvement or relapse if
untreated.
 Complications
• Intestinal hemorrhage and perforation
• Neurological: encephalopathy, meningitis
• Other: hepatitis, osteomyelitis, myocarditis,
pneumonia
• Chronic carriage (esp. in gallbladder)
 Diagnosis
• Gold standard: Blood culture (especially in the
first week)
• Widal test: Detects agglutinating antibodies to
O and H antigens
• Other tests: Stool and urine culture, Typhi dot,
complete blood count
 Differential Diagnosis
• Malaria – fever with chills, splenomegaly
• Dengue – sudden onset, rash, low platelet
count
• Amoebiasis – abdominal pain, dysentery
• Brucellosis – joint pain, fever
• Tuberculosis – chronic illness,
lymphadenopathy
 Homeopathic Management
• Focus on individualization and totality of
symptoms
• Acute and chronic phase remedies considered
• Support vital force and stimulate healing
response
 General Management
• Maintain hydration with oral rehydration
solution
• Light, nutritious diet: boiled rice, banana, curd
• Monitor vitals and ensure bed rest
• Maintain hygienic environment
 Prevention
• Handwashing with soap
• Avoiding raw or undercooked food
• Safe drinking water (boiled or filtered)
• Typhoid vaccine (injectable or oral)
 Prognosis
• Early treatment leads to full recovery in most
cases
• Untreated cases may lead to death or
complications
• Chronic carriers may unknowingly transmit
infection for years
 Conclusion
• Typhoid fever is a major public health concern
in endemic areas.
• Homeopathy can offer supportive and curative
options when individualized properly.
• Prevention through education, hygiene, and
vaccination is essential.
 References
• - WHO Typhoid Fever Factsheet
• - Davidson's Principles and Practice of
Medicine
• - Boericke’s Materia Medica
• - Various peer-reviewed journals and case
studies
 Detailed Pathophysiology
• Salmonella enters the Peyer's patches of the
ileum, is engulfed by macrophages and
survives intracellularly.
• It spreads to the reticuloendothelial system
causing systemic symptoms.
• The bacteria reenter the bowel, causing
ulceration and possible perforation.
 Laboratory Investigations
• Blood culture: Best sensitivity in first 7-10 days
• Widal test: O and H agglutinin titres
• Stool/urine cultures: Useful in later stages
• Rapid tests: Typhi Dot, ELISA, PCR (if available)
 Radiological Findings
• X-ray: Air under diaphragm in case of
perforation
• Ultrasound: Hepatosplenomegaly, mesenteric
lymph nodes
• CT scan: Used for complications such as
abscesses or perforation
 Typhoid Carrier State
• Occurs in ~2-5% of patients after recovery
• Chronic carriers harbor bacteria in gallbladder
or urinary tract
• They may be asymptomatic but contagious
• Gallbladder removal may be required in
persistent cases
 Comparative Systems of Medicine
• Allopathy: Ceftriaxone, Azithromycin,
Fluoroquinolones
• Ayurveda: Herbs like Guduchi, Musta, Amalaki
• Homeopathy: Individualized remedy selection
based on symptoms and constitution
 Homeopathic Remedy
Differentiation
• - Baptisia: Confused, toxic state, fetid
discharges
• - Arsenicum Album: Great restlessness,
burning pain, thirst for sips
• - Rhus Tox: Restlessness with body ache,
worse at rest
• - Gelsemium: Prostration, chills up the spine,
dullness
• - Pyrogenium: Discrepancy between pulse and
temperature
 Case Study Example
• Case: 21-year-old female, high step-ladder
fever, coated tongue, lethargy
• Diagnosis: Blood culture confirmed *S. typhi*
• Remedy given: Arsenicum Album 200
• Outcome: Fever reduced in 3 days, full
recovery in 10 days
 Preventive Measures in
Community
• Improve water quality and sanitation
infrastructure
• Routine vaccinations in high-risk zones
• Community education on hygiene practices
• Regular screening of food handlers
 Role of Government & WHO
• Government: Integrated Disease Surveillance
Program (IDSP)
• WHO: Typhoid Vaccine Implementation
Program
• Monitoring, outbreak response, and health
education campaigns
 Summary & Takeaway
• Typhoid is a systemic disease with significant
public health impact
• Homeopathy offers a safe, effective adjunct
when selected accurately
• Hygiene, vaccination, and early diagnosis are
pillars of prevention and management