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== Physical examination ==
== Physical examination ==
{| class="wikitable"
|- valign="top"
! Organ System
! First Week
! Second Week<ref name="pmid22357703">{{cite journal| author=Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD et al.| title=A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009. | journal=Clin Infect Dis | year= 2012 | volume= 54 | issue= 8 | pages= 1091-9 | pmid=22357703 | doi=10.1093/cid/cis025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22357703  }} </ref>
! Third Week
|- valign="top"
! rowspan="1" | General Appearance
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|- valign="top"
! rowspan="1" | Skin
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|- valign="top"
! rowspan="1" | HEENT
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|- valign="top"
! rowspan="1" | CV
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|- valign="top"
! rowspan="1" | Pulmonary
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|- valign="top"
! rowspan="1" | Abdomen
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|- valign="top"
! rowspan="1" | Neurological
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|- valign="top"
! rowspan="1" | Musculoskeletal
| colspan="1" style="width: 400px;" | First week findings
| colspan="1" style="width: 400px;" | Second week findings
| colspan="1" style="width: 400px;" | Third week findings
|}
*Slowly rising temperature with relative [[bradycardia]]
*Malaise
*Headache
*Cough
*[[Epistaxis]]
*Abdominal pain 
*Prostration
*High grade fever which plateaus around 40°C
*Bradycardia (Sphygmo-thermic dissociation), classically with a dicrotic pulse wave.
*Delirium or agitation (nervous fever)
*Rose spots on the lower chest and abdomen(1/3 patients).
*[[Rhonchi]] in lung bases.
*Painful abdomen(right lower quadrant).
*Diarrhea (six to eight stools/day), green with a characteristic smell, comparable to pea-soup.<ref name="pmid1899554">{{cite journal| author=Gotuzzo E, Frisancho O, Sanchez J, Liendo G, Carrillo C, Black RE et al.| title=Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area. | journal=Arch Intern Med | year= 1991 | volume= 151 | issue= 2 | pages= 381-2 | pmid=1899554 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1899554  }} </ref>
*Constipation 
*Intestinal hemorrhage
*Intestinal perforation in distal [[ileum]](Fatal)
*[[Septicaemia]] or diffuse [[peritonitis]]<ref name="pmid6361558">{{cite journal| author=Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR et al.| title=Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone. | journal=N Engl J Med | year= 1984 | volume= 310 | issue= 2 | pages= 82-8 | pmid=6361558 | doi=10.1056/NEJM198401123100203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6361558  }} </ref> 
*[[Encephalitis]]
*Metastatic abscesses
*[[Cholecystitis]]
*[[Endocarditis]]
*Osteitis
*Defervescence


== References ==
== References ==

Revision as of 17:29, 31 August 2016


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Physical examination

Organ System First Week Second Week[1] Third Week
General Appearance First week findings Second week findings Third week findings
Skin First week findings Second week findings Third week findings
HEENT First week findings Second week findings Third week findings
CV First week findings Second week findings Third week findings
Pulmonary First week findings Second week findings Third week findings
Abdomen First week findings Second week findings Third week findings
Neurological First week findings Second week findings Third week findings
Musculoskeletal First week findings Second week findings Third week findings
  • Prostration
  • High grade fever which plateaus around 40°C
  • Bradycardia (Sphygmo-thermic dissociation), classically with a dicrotic pulse wave.
  • Delirium or agitation (nervous fever)
  • Rose spots on the lower chest and abdomen(1/3 patients).
  • Rhonchi in lung bases.
  • Painful abdomen(right lower quadrant).
  • Diarrhea (six to eight stools/day), green with a characteristic smell, comparable to pea-soup.[2]
  • Constipation



References

  1. ↑ Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD; et al. (2012). "A large outbreak of typhoid fever associated with a high rate of intestinal perforation in Kasese District, Uganda, 2008-2009". Clin Infect Dis. 54 (8): 1091–9. doi:10.1093/cid/cis025. PMID 22357703.
  2. ↑ Gotuzzo E, Frisancho O, Sanchez J, Liendo G, Carrillo C, Black RE; et al. (1991). "Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area". Arch Intern Med. 151 (2): 381–2. PMID 1899554.
  3. ↑ Hoffman SL, Punjabi NH, Kumala S, Moechtar MA, Pulungsih SP, Rivai AR; et al. (1984). "Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone". N Engl J Med. 310 (2): 82–8. doi:10.1056/NEJM198401123100203. PMID 6361558.

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