Typhoid

Typhoid is caused by bacterium Salmonella Typhi and is spread by drinking contaminated water. Those suffering from typhoid carry this bacteria in their intestinal tract and blood. Even after recovery from the typhoid fever, the bacteria continue to reside leading to spread of the disease.

Eating food handled by a carrier leads to the spread of typhoid. Typically typhoid fever goes as high as 103° to 104° F. The patient suffers stomach pain, headache, gastroenteritis, weakness and loss of appetite. It can also result in rose-colored rashes, known as 'rose spots' in the abdomen. Some might notice epistaxis (bleeding from the nose) and swelling in the abdomen. As the disease progresses, there might be delirium and agitation. If typhoid fever continues into the third week, there might be life-threatening complications such as intestinal hemorrhage, Cholecystitis (inflammation of the Gallbladder) and intestinal perforation. Intestinal leakage could lead to intense irritation and inflammation of the abdominal cavity - a condition known as Peritonitis which can be fatal.

Other Complications:

• There might be a decrease in WBC count and blood culture tests may show positive for Salmonella typhi or paratyphi.
  
• The spleen and liver might become enlarged.
  
• Anemia owing to intestinal bleeding
  
• Lowered body defenses could not fight against bacterial infections like Streptococcus Pneumoniae
  
• Infection may spread to heart or brain causing Meningitis and even coma.
  

If typhoid is diagnosed early, antibiotics for about 7 - 14 days are prescribed. The patient must be given plenty of fluids and small meals. Plenty of bed rest is needed to recoup from a bout of typhoid.

Leukopenia

Leukopenia is a condition wherein the leukocyte count in the blood is low. Low WBC or White Blood Cells indicate decrease in disease fighting cells circulating in the blood. Some of the common causes for low WBC count:

Viral infections Any viral infections may disrupt bone marrow function for a short duration thus producing low counts of white blood cells. Infections like typhoid, influenza may lower the white blood cell count.

Congenital disorders may weaken bone marrow function, a WBC spectrum test can confirm any such congenital disorder.

Kostmann's syndrome is a congenital disorder wherein the neutrophil production is low.

Myelokathexis Neutrophils fail to enter the blood stream.

Infectious disease HIV destroys the WBC and leaves the person susceptible to infections.

Malnutrition

Vitamin or mineral deficiencies

Parasitic diseases

Autoimmune disorders may destroy white blood cells or bone marrow cells.

Aplastic anemia In this condition the bone marrow does not produce enough of any of the cells including white blood cells. This condition may set in all of a sudden or can develop and progress gradually. Few drugs, pregnancy, radiation therapy or chemotherapy can trigger this condition.

Lupus is an auto immune disease wherein the body fights with its own immune system thus destroying white blood cells.

Chemotherapy and radiation therapy are used to kill cancerous cells. They however destroy healthy white blood cells thus leaving the patient with low WBC count. This is one major reason why cancer patients are unable to fight diseases or infections in general.

Leukemia is a type of cancer wherein the body produces too many white blood cells that are abnormal. These white blood cells are not active white blood cells that can fight infections. People down with leukemia have low white blood cell count as their bone marrow is producing more of the abnormal white blood cells.

Cancer may also damage the bone marrow.

Hyperthyroidism An overactive thyroid can produce lower number of white blood cells. The medication used for thyroid can reduce the white blood cell count in the blood.

Liver disorder/Spleen disorder Hypersplenism, in which blood cells are destroyed prematurely by the spleen. An enlarged spleen also known as splenomegaly can trigger low white blood cell count.

Stool Culture

Gastroenteritis and bacterial diarrhea are the most common forms of infections that occur both in children and adults. These infections are predominant in tropical regions. The most common etiology for diarrhea is either through parasitic infections or bacterial infections. Both these forms have distinctive clinical characteristics. The identification of the type of disease caused can provide a comprehensive route to differentiate and treat the disease through appropriate anti-parasitic or anti-microbial drugs.

Clinical symptoms

Gastroenteritis or enteric fever identification is characterized by abdominal discomfort, diarrhea and extreme dehydration. In most cases, these kinds of infections occur because of food or water borne contamination. The differential diagnosis of this condition in order to identify the disease is done through additional clinical symptoms, physiological changes and bio-chemical metabolic pathways. One of the most important factors in the identification of bacterial enteric fever is the presence of associated sepsis and spiking fever. In addition to this, in epidemic and highly infectious diseases like Cholera, caused by Vibrio cholera, the cyclic AMP(adenosine mono phosphate) levels are elevated leading to intense dehydration which can be fatal if left unattended.

Diagnosis

In case of bacterial enteric fever or associated diarrheas, stool specimens help understand and identify the type of organism causing the disease. Stool specimens are collected by patients in sterile container and the areas of stool in which blood and mucous are present are used for processing as they are useful portions of the specimen. The obtained media is usually transported by incorporating a transport media to avoid bacterial count decline because of varied PH of the external environment.

Microbiological media such as Selenite feces broth, Mackonkey agar, Salmonella Shigella agar, TCBS medium and Nagglers medium are used in the culture laboratory to identify disease causing organisms such as Salmonella(Typhoid, enteric fever) Shigella( Diarrhea) E.coli 0167or entero - hemorrhagic (Traveler's Diarrhea), Clostridium Botulinum(Food poisoning), Vibrio cholera( Cholera) and Campylobacter.

Apart from these bacteria, stool cultures are also done to identify the presence of enteric viruses such as Rota virus which causes viral gastroenteritis. All organisms isolated are subjected to respective antimicrobial assay to determine the suitable drugs for the respective organism. Careful precautions are taken and clinical details of the patient are recorded by the microbiologist to administer specific drugs for specific organisms. This helps to prescribe medications to specific persons too, such as pregnant and lactating women and children.