Clinic Consult Pediatrics: Typhoid Ritabrata Kundu, Jaydeep Choudhury
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Jaydeep Choudhury DNB (Ped) MNAMS FIAP Professor Department of Pediatrics Institute of Child Health Kolkata, West Bengal, India Ritabrata Kundu MD (Ped) FIAP Professor Department of Pediatrics Institute of Child Health Kolkata, West Bengal, India
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Clinic Consult Pediatrics: Typhoid/ Jaydeep Choudhury, Ritabrata Kundu
First Edition: 2020
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Typhoid is one of the most common infectious diseases in the Indian subcontinent. The typical presentation is fever, but it has a wide range of manifestations and some children may require hospital admission.
Southeast Asia, South-central Asia and parts of Africa reports high incidence of Salmonella typhi infection, accounting for more than 100 cases per 100,000 person-years. Salmonella paratyphi also accounts for a substantial proportion of enteric fever cases in areas of South Asia but it remains uncommon in Africa. Lack of consistent reporting from different areas of the world is the main limitation for getting a true picture of global scenario.
Humans are the only reservoir for S. typhi but a specific source or contact is identified only in a small number of cases. A typhoid case or carrier is the source of infection but often unnoticed.
Specific diagnosis of an infectious disease like typhoid has several advantages. It helps in reducing the financial expense considerably. Prompt and appropriate antimicrobial therapy can be initiated, which ensures prevention of antimicrobial resistance. The threat of extensively drug-resistant typhoid (XDR typhoid) is looming on the horizon; our neighboring country Pakistan has reported good number of cases. Proper preventive measures can help to reduce the disease burden in a large way. It is needless to say that a good microbiology laboratory is vital in the isolation and identification of organisms including resistance pattern.
Monotherapy is still the thumb rule for antibiotic treatment of typhoid fever. Antibiotics in appropriate doses ensure good response and prevent further complications. It is heartening to note that typhoid is again becoming susceptible to the first-line antibiotics, though their routine use is not recommended at present. The cost of treating typhoid has escalated with the use of third-generation cephalosporins. Rampant indiscriminate use of azithromycin will make this easily available cheap drug useless in the coming years. It is important that azithromycin is used judiciously.
Environmental protection is one of the vital issues in prevention of typhoid in the community level. It is imperative that mass scale sanitary and personal hygiene improvement is a difficult proposition. Vaccination against typhoid is an important preventive strategy on an individual basis.
The chapters compiled in this book cover the various aspects of typhoid in a concise easy to read presentation. This book is meant for all the medical practitioners who treat patients suffering from typhoid and also for undergraduate and postgraduate medical students.
Jaydeep Choudhury
Ritabrata Kundu
We are deeply indebted to the innumerable patients suffering from typhoid who attend our hospital. They have taught us the most.
We would like to express our gratitude to Professor Apurba Ghosh and Professor Maya Mukhopadhyay for always being kind and supportive to us for all our endeavors. Whenever we undertake any academic project we remember Late Dr Tapan Kumar Ghosh who has influenced our lives in many ways.
Our honest appreciation for Mr Somnath Mukherjee and Ms Ruma Saha for secretarial assistance during preparation of the manuscript.
Sincere gratitude to our family members for being supportive to us.
We appreciate the support and cooperation that we have always received from Shri Jitender P Vij (Chairman and Managing Director), Mr Ankit Vij, Mr Shashi Kumar Sambhoo, Dr Neeraj Choudhary, Ms Sudarshna Agarwal, Mrs Samina Khan and the team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi and Mr Sandeep Gupta, Mr Sabyasachi Hazra and the team from Kolkata Branch for their whole-hearted effort and cooperation.