Unit iii

 Typhoid Fever
 Bacillary Dysentery
 Cholera
 Food Poisoning
 Leptospirosis

 Amoebiasis
 Schistosomiasis
 Capillariasis
 Helminths
 Trichinosis
 Ancylostomiasis
 Ascariasis
 Enterobiasis
 Taeniasis
 Trichuriasis
 Paragonimiasis
 Strongyloidiasis
 Red Tide
Poisoning

is a general infection caused by
Salmonella Typhi involving primarily
the lymphoid tissues (Peyers Patches)
of the small intestine.
is a bacterial infection transmitted by
contaminated water, milk shellfish or
other foods

Salmonella Typhosa or Salmonella Typhi
Fecal Oral route
Rose Spot on the Abdomen
10-20 days

– as long as the bacteria are
excreted therefore another
important source of infection is
the stool of the patient

1. PRODROMAL OR GRADUAL ONSET/
INITIAL STAGE
Fever, Abdominal pain, diarrhea
Irregularly spaced small rose spot
on the abdomen, chest, trunk, and
back

2. FASTIGIAL STAGE
1. Ladderliked fever or stairway fever
2. Rose pot
3. Splenomegaly enlargement of the spleen

2. FASTIGIAL STAGE
Abdominal symptoms may become
marked abdominal distention
(tympanites)
Teeth and lips accumulate a dirty brown
collection of dried mucus and bacteria
known as (typhoid state)

 Restless alteration in the level of
consciousness
 Carphologia
– involuntary picking of linens
 Subsultus Tendinum
– involuntary twitching of the
tendon of the wrist

WIDAL TEST
– agglutination test for typhoid fever
3 ANTIGEN USE
– positive active typhoid state or
acute infection
exposed before to typhoid fever
Immunized with cholera typhoid
– are found among carriers

3. STAGE OF DEFERVESCENCE
Circulation
PEYERS PATCHES
INFLAMMATION
MEMBRANE
Slough or falls off
MELENA

HEMATOCHEZIA
– fresh blood in the stool
–inflammation of the lining tissue
of the abdominal cavity

4. LYSIS - or CONVALESCENCE STAGE

 WIDAL TEST
 RECTAL SWAB
CHLORAMPHENICOL

1. Symptomatic
2. GI Bleeding (NPO) Blood Transfusion
may be given to patient
3. Avoid spicy food cause irritation of
gastric mucosa and aggravate the
bleeding of the pt.
4. Encourage increase fluid intake the
patient may become dehydrated due
to water loss vomiting diarrhea and
poor oral intake.
5. Give a high calorie low residue diet
during febrile stage

 Immunization ( Cholera Typhoid )
 Avoid the 5 Fs
 Proper disposal of feces
 Avoid breeding places of flies
 Proper preparation cooking storage of
food
 Proper handwashing
 Cut finger nails

an acute bacterial disease of the
intestinal tract includes a group of
enteric infections caused by bacilli of the
shigella group

 Shigella Flexneri
 Shigella Sonnei
 Shigella dysenteriae
Fecal oral

1-7 days average 3-4 days
feces of infected persons,
contaminated food and water

1. Fever is an initial manifestation
2. Vomiting and headache
3. Colicky or cramping abdominal pain
and tenderness together with
anorexia, malaise
4. Persistent diarrhea at first watery
bloody and later stools contain blood
mucus and very scanty fecal
substance

5. Bowel movement are numerous
accompanied by abdominal cramps
and tenesmus, Which is manifested
by infants by crying and straining
during defecation even without
passage of fecal matter

1. Fluid and electrolyte replacement
2. Giving of ORS
3. Peri Anal care
4. Observe for S/S of dehydration
 Sunken eyeballs
 Sunken fontanelle
 Dry skin
 Poor skin turgor
 Scanty urine out put
 Excessive thirst

1) Sanitary waste disposal
2) Screening of food handlers
3) Hand washing
4) Avoid breeding places of flies

Is a severe gastro intestinal disease
characterized by vomiting and massive
watery diarrhea with rapid dehydration
and shock
Vibrio Coma
Vibrio Cholerae (Classic and Eltor)

a. Fecal oral route
b. Ingestion of food or water
contaminated with stool or vomitus of
pts.
c. Fluid soiled hands and utensils
Rice watery stool
few hrs 5 days ( 1-3 days)

Massive or profuse diarrhea watery
voluminous whitish, grayish or
greenish slightly mucoid stools without
fecal matter
Stools are passed repeatedly later
becoming almost continuous without
straining or tenesmus
Signs of Severe dehydration
Loss of voice
Oliguria

Fever may be low grade or moderate
at the start but becomes subnormal in
later stages especially when shock
occur

1. Extracellular volume loss due to
intestinal loss of isotonic fluid leading
to:
a) Profound on severe dehydration
with washerwomans hands,
restlessness and extreme thirst
b) Circulatory collapse or shock
2. Acidosis due to loss of large volume
of bicarbonate rich stools
3. HYPOKALEMIA – due to continuous
fecal potassium loss may manifest as
distention due to paralytic ileus

 Acidosis and Shock
 Renal failure and Uremia
 Respiratory Complications like
pneumonia
Rectal swab
Tetracycline

1) Early and intensive management of
fluid and electrolytes imbalance
2) Oral rehydration to prevent
dehydration
3) Peri anal care

1. Boiling of drinking water
2. Immunization
3. Avoid the 5 F’S

FOOD POISONING
Denotes a clinical situation which
occurs after ingestion of certain
contaminated food stuffs or other
materials which are poison in
themselves. It has been found that the
poisoning is a gastro enteritis often
produced by the presence of a disease
organism or its toxins

6 – 48 hours
foods rich in CHON
 Fever
 Nausea and vomiting
 Diarrhea, if severe there is blood

STAPHYLOCOCCUS PRODUCE A
POWERFUL ENDOTOXIN
2 – 6 hours

foods rich in carbohydrates
 Fever
 Abdominal pain,
 Cold Clammy Skin
 Easy fatigability
 Diarrhea

canned goods
 headache
 gradual paralysis
 death within 24 hrs. if not treated
24 hours

1. CBR
2. Increase fluid intake
3. Encourage the pt. to vomit
4. Oral hygiene

1. Check the expiration date
2. Bulging of the can goods
3. Change in appearance shape, of
foods.
• Presence of bubbles
• Smell if it to mushy
4. Cooking or reheating of foods may
kill the organism

This infection is carried by animals
both domesticated and wild whose
excreta contaminated water or food
which is ingested or inoculated
through the skin or mucous membrane

 Ingestion
 Inoculation
 break on the skin
Leptospira
6 – 15 days

1. AGE
2. Season high incidence during rainy
season
3. Geographic more prevalent in slum
areas heavily infested by wild rats
wild rats
orange colored eyes

 Febrile lasting 4-7 days
 Chills,
 Headache
 Muscle pain severe prostration
 Nausea and vomiting

 Headache
 Fever
 meningeal irritation with CSF
findings of aseptic meningitis
WITH or without Jaundice lasting 4-
30 days if severe death may occur
between 9th and 16th day

 Hepatic and renal manifestation
 Jaundice
 Renal involvement oliguria, and
anuria with progressive renal failure

 Shock Coma and congestive heart
failure are also seen in severe
cases

1. Pneumonia
2. Iridocyclitis
3. Peripheral Neuritis
- Leptospira Agglutination Test
– Leptospira Antigen
Antibody Test

A. Symptomatic
B. Urine must be properly disposed
C. Cleaning of dirty places, pools,
stagnant water
Penicillin
Eradication of Wild Rats

HEPATITIS
is a diffuse inflammation of the liver
parenchyma caused by a virus
Hepa A
B
Non A and Non B
D
E

HEPATITIS
– Infectious hepatitits
Has An acute or abrupt clinical onset
cause by RNA type virus of the
entero virus family

2 - 6 weeks
Feces
fecal oral route

~children and elderlies
~rainy season
~none
Those with poor
environmental sanitation
Food handlers
Those who practice oral anal sex

1. Proper environmental sanitation
2. Screening of food handlers
3. Avoid oral anal sex
5 % mortality

HEPATITIS
– Serum hepatitits
Is a double shelled particle
containing DNA type virus which
were called serum hepatitis

6 weeks – 6 months
blood, semen, vaginal secretions
percutaneous inoculation, sexual contact

~all ages
~all season
~yes
Members of the health team
Drug addicts contaminated needles
that are using
Clients undergoing hemodialysis
Promiscuity multiple sexual
partners

1. Immunization
2. Use of sterile syringes needles
3. Screening of blood donors
1-10% Mortality lead to
carrier and cirrhosis of the liver

HEPATITIS
post transfusion hepatitis
A viral infection that at present does
not have identified the agent or
antigenic markers

2 weeks – 6 months
blood
blood transfusion
other viruses

~all ages
~all season
~yes
blood recipient
Client undergoing surgery

screening of blood donors
1-2% Mortality

HEPATITIS
Hepatitis Delta
Hepatitis E Et Non A Non B
enterically transmitted non A non B

 Fever
 RUQ pain
 nausea and vomiting
 anorexia flu
 Presence of jaundice
 Pruritus
 Tea colored urine
 Clay or gray colored stool
 Acholic stool – clay colored stool
 Hepatomegaly

1. Liver function test
2. Bilirubin exam.
3. Liver enzymes test
4. Ultrasound of the liver
A. Liver profile test
B. HBSAG – hepatitis B

No specific treatment
Essentiale acts as a liver protector
Bed Rest
Increase carbohydrate , increase
protein, low fat diet
Hard candies
Skin care

Is an acute viral infection of the
salivary glands particularly the
parotids with constitutional
manifestations of varying degrees

14 – 25 days
From 6 days before until 9 days after
the parotid glands swell
MUMPS VIRUS, Paromyxovirus

 direct by person to person contact
 droplet or airborne infection
 With the oropharynx as the portal of
entry
discharges coming from nose and
mouth of infected person 9 Saliva of
the pt.

1. Slight malaise, with low grade fever
2. Pain below the ear particularly in
moving the jaw
childhood disease with a peak of age
5 – 15 years old
life long Immunity

 Orchitis - common complication
among men
FEMALE vulvitis.Vaginitis rare
compare it to male
no specific
Ice cooling effect it only
relieve the pain

CBR
Avoid lifting heavy object
Ice compress
Never give sour foods
Oral hygiene
Mumps Vaccine

Refers to infection of men by
Entamoeba Histolytica involving the
colon but may spread to other soft
tissue organs by contiguity or
hematogenous or lymphatic
dissemination most commonlt to the
liver or lungs

2 – 4 weeks
fecal oral route ingested the cyst
form of parasites
Entamoeba Histolytica

1. Fever
2. Abdominal pain
3. Flatulence
4. Blood streaked mucoid stool
5. Foul smelling stool
6. Diarrhea alternating with constipation
Stool Exam: stool must be fresh

1. Isolation of Patient
2. To avoid spread of disease by health
teachings to the pt. and his family
 Boil water when or before drinking
 Cover left over foods
 Handwashing after defecation,
before eating
Flagyl

1. Isolation of Patient
2. To avoid spread of disease by health
teachings to the pt. and his family
Flagyl
Avoid the 5 F’S

Schistosoma japonicum
Schistosoma mansoni
Schistosoma haematobium
3 SPECIES OF BLOOD FLUKES

Snail (Oncomelania Quadrasi)
Framers and fishers
2 months

Egg
hatches
miracidium
CERCARIA
Penetration
Feet
Male
and
Female
Flukes
copulation

1. Fever
2. Abdominal pain diarrhea
3. Emaciated
4. Melena
Stool Exam
COPT Circum Oval Precipitin TEST

Praziquantrel
TREATMENT
Stibophen ( fuadin )

Snail control
Spraying of snail poison
Construction of irrigation system
Proper cultivation technique



Proper disposal of feces
Wearing of protective foot covering
Making of foot bridges


Tagudin or Pudoc Ilocos Sur
Capillaria philippinensis

 Fever
 Abdominal pain diarrhea with borborygmi
ingestion of uncooked brackish
water fish

Stool exam
Metronidazole
Avoid eating of uncooked brackish
water fish

~Spiralis type of worm round worm
eating or ingesting uncooked pork
(meat, fats)
~Ancylostoma Duodenale
walking barefooted

~ Ascaris lumbricoides giant
intestinal round worm
soil and food contaminated with feces
~ Enterobium
vermicularis (PIN WORM)

~ Enterobium
nocturnal anal itchiness

~ Enterobium
Tape TEST

~ Taenia saginata, Taenia
sollium, Diphyllabothrium latum
beef tape worm
pork tape worm
fish tape worm

 – Trichuria whip worm

ingestion of uncooked crabs
hemoptysis

 – Strongyloid
stercoralis thread worm
 Voracious eater
 Pot belly
 Malnourish and anemic

 Avoid the 5F’s
 Avoid walking barefooted
 Personal hygiene
Stool exam
Giving of antihelmenthics

RED TIDE POISONING – PSP
Plankton
ingestion of contaminated shell fish

 Headache numbness and tingling
sensation around the mouth
 Gradual paralysis death within 24 hrs.
if not treated right away
Type of food eaten by the patient

 Complete Bed REST
 Induce the pt. to vomit
 Increase fluid intake
 Oral Hygiene
Supportive
Avoid Eating shell fish

Unit iii

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Unit iii