A site for medical students - Practical,Theory,Osce Notes

What are the features of enteric fever in its first week?

Following are the features of enteric fever in the first week

  • Step-ladder pattern of pyrexia.
  • Frontal headache.
  • Constipation.
  • Anorexia, nausea, cough and epistaxis.
  • Flushed face with toxic look.
  • Angry looking tongue, central coating with red tip and margins
  • Caecal gurgling.
  • Relative bradycardia and rarely dicrotic pulse
  • Appearance of rash on the 7th day (usually appears on 7th-10th day).
  • The spleen may be just palpable, soft and tender spleen at the end of first week is seen

What is typhoid state ?

If the enteric fever is untreated it may enter into a toxemic phase towards the end of 3 week and is manifested as the following
  • Semiconsciousness or unconsciousness.
  • Low muttering delirium.
  • Coma vigil - Patient lies with half-open eyes but ignorant of his surroundings
  • Carphology manifested as picking of bed clothes
  • Sub sultus tendinus this is the involuntary movement of the fingers and wrist
  • Convulsions rarely.