thyphoid fever

bacteria                             = salmonella typhi
transmission through        = fecal oral
                                           =contaminated water@food
clinical manifestation
= prolong fever (pyrexia of unknown origin with stepladder pattern)
= constipation in early of the disease followed by diarrhea
= diarrhea and vomiting in children
= malaise
= increasing headache
= relative bradycardia
= end of first week :- rose spot (rash)
= 7th - 10th day :- spleen is palpable                                  ( clinical manifestation=from Davidson's         
= abdominal distension and tenderness                                  principal and practice of medicine )          

#  caldinal sign

• fever -stepladder pattern
• relative bradycardia
• spleen palpable
• rose spot
• characteristic toxemia 

Pathogenesis :