* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download cAUSES OF FEVER
Survey
Document related concepts
African trypanosomiasis wikipedia , lookup
Oesophagostomum wikipedia , lookup
Hepatitis C wikipedia , lookup
Orthohantavirus wikipedia , lookup
Chagas disease wikipedia , lookup
Hepatitis B wikipedia , lookup
Schistosomiasis wikipedia , lookup
Yellow fever wikipedia , lookup
Tuberculosis wikipedia , lookup
1793 Philadelphia yellow fever epidemic wikipedia , lookup
Traveler's diarrhea wikipedia , lookup
Yellow fever in Buenos Aires wikipedia , lookup
Rocky Mountain spotted fever wikipedia , lookup
Leptospirosis wikipedia , lookup
Transcript
1 2 cAUSES OF FEVER CAUSES OF FEVER ENDOGENOUS FACTORS ANTIGENANTIBODY REACTION MALIGNANCY & GRAFT REJECTIONS EXOGENOUS FACTORS BACTERIA OR FUNGI 3 EXOGENOUS FACTOR INFECTION DUE TO BACTERIA OR FUNGI ACTIVATION OF PHAGOYTES IN THE BONE MARROW RELEASE OF PYROGEN SYNTHESIS OF PROSTAGLANDIS THERMOREGULATORY CENTRE IN THE ANTERIOR HYPOTHALAMUS INCREASE IN THE TEMPERATURE 4 TYPES OF FEVER TYPES OF FEVER ACUTE SHORT DURATION ACCOMPANY INFECTIONS LIKE- TONSILITIS, TYPHOID, INFLUENZA TEMPERATURE MAY RISE TO 104 F INTERMITTENT ALSO CALLED RECURRENT FEVER REPEATED EPISODES OF HIGH FEVER MALARIA CHRONIC LONG DURATION TEMPERTURE MAY REMAIN LOW BUT LONGER TIME PERIOD. HAS SLOW, GRADUAL ONSET & LOW IN SEVERITY 5 METABOLISM IN FEVER 7% increase in BMR with every 1F increase in body temperature or 13% increase with every 1C rise in body temperature. Glycogen & adipose tissue stores decrease significantly. Rate of protein catabolism increases. Loss of body fluid in the form of excessive sweat & urine formation. Increased loss of minerals. Absorption of nutrients decreases. CURRENT SLIDE 6 SYMPTOMS OF FEVER Loss of appetite Loss of weight Severely emaciated 7 GENERAL DIETARY CONSIDERATIONS ENERGY-: Increases about 50%. Restlessness also increases the calorie requirement. PROTEIN-: About 100g protein or more is prescribed. High protein beverages may be used as supplements to the regular meals. CARBOHYDRATES-: Glycogen stores are replenished by a liberal intake of carbohydrates. BACK 8 Glucose is preferred. FATS-: Energy intake can be increased through the use of fats. Fried foods & rich pastries may retard digestion. MINERALS-: A sufficient intake of salt is necessary. Fruit juices & milk are good sources. VITAMINS-: Requirement of vitamin A & ascorbic acid with B-complex vitamins are increased. 9 Oral therapy interfere with the synthesis of Bcomplex vitamins. FLUID-: Liberal fluid intake is preferred. Daily, 2500-3000 ml of fluid is necessary. EASE OF DIGESTION-: Blend, readily digested food should be used. The food may be soft & of regular consistency. Fluid diet can be used initially INTEVALS OF FEEDING-: Small quantities of food at interval will permit adequate nutrition. Soft or liquid foods as desired should be offered. Sufficient intake of fruits & salt is essential. 10 11 ACYTE FEVER- TYPHOID Infectious disease caused by a bacteriaSalmonella typhosa. Salmonella schottmulleri causes parathyroid B. 12 CAUSATIVE ORGANISM-: Do not multiply in water. May survive for over a month in ice & ice cream. Grow rapidly in milk. Gram- negative Motile Grows best at human temperature. • INCUBATION PERIOD-: 10-14 days. 13 DEVELOMENT OF DISEASE-: SMALL INTESTINE LYSIS OF BACTERIA BY ANTIBODIES LIBERATION OF ENDOTOXIN BACTERIA ATTACH TO INTESTINAL WALL REACH BLOOD STREAM GENERALISED SYMPTOMS PENETRATION MULTIPLY IN LYMPHNODES FEVER 14 BACTERIA MOVES TO ESTABLISH A SECONDARY INFECTION DIARRHOEA LIVER SECRETED INTO INTESTINE CHRONIC CARRIERS GALL- BLADDER BILE DUCTS 15 TRANSMISSION OF DISEASE FLYING INSECTS FEEDING ON FECES ASYMPTOMATIC CARRIER OF TYPHOID FEVER 16 DIAGNOSIS OF TYPHOID FEVER Diagnosis is made by any blood, bone marrow or stool cultures and with the Vidal test. The Vidal test is time consuming and oftentimes when diagnosis is reached it is too late to start an antibiotic regimen. 17 Continued , high inflammation of the intestine. Formation of intestinal ulcers Loss of tissue proteins Disturbance in water electrolyte balance Haemarrhage Enlargement of spleen Payer’s patches or flat patches of lymphatic tissue. Diarrhoea or constipation Severe stomach ache Abdominal absorption of nutrients decrease Feeling of headache & anorexia. CURRENTSLIDE 1 CURRENT SLIDE 2 18 PREVENTION & TREATMENT Sanitation and hygiene are the critical measures that can be taken to prevent typhoid. Careful food preparation and washing of hands are crucial to preventing typhoid. There are two vaccines currently recommended by the World Health Organization for the prevention of typhoid:these are the live, oral Ty21a vaccine and the inject able Typhoid polysaccharide vaccine. Typhoid fever in most cases is not fatal. Antibiotics, such as ampicillin, chloramphenicol, Amoxicillin and ciprofloxacin, have been commonly used to treat typhoid fever. 19 Treatment of typhoid includes-: Rest in bed Keeping the patient warm Antibiotic therapy A modified diet 20 To maintain adequate nutrition To restore positive nitrogen balance To provide relief from symptoms To correct & maintain water & electrolyte balance To avoid irritation of intestinal tract 21 ENERGY-: BMR increases by about 50% Restlessness also increases the energy expenditure Increase energy by 10-20% PROTEIN-: Increased to 1.5- 2 times than normal i.e. 1.52g protein /kg body wt/day Protein foods of high biological value should be included CARBOHYDRATES-: A liberal intake of carbohydrate is suggested For protein sparing action BACK 22 Well cooked, easily digestible carbohydrates should be included. More of glucose can be used DIETARY FIBRE-: All harsh, irritating fibre should be avoided FATS-: Emulsified fat should be given Fried food should be restricted MINERALS-: Salty soups, broths, fruit juices, milk etc should be included Fe supplementation is also important VITAMINS-: Increase the amount of vitamin A & C Requirement of vitamin B also increases BACK 23 FLUID-: Liberal intake of fluid is necessary Fluid may be included in the form of beverages, soups, juices, plain water etc. 24 • HIGH ENERGY, HIGH PROTEIN & FULL FLUID DIET • SMALL MEALS AT FREQUEN T INTERVL • A BLAND, LOW FIBRE, SOFT DIET • AVOID ALL IRRITATIN G FOODS ADEQUATE NUTRITION DIET & FEEDING PATTERN EASILY DIGESTED & ABSORVABLE ILL AND ANOREXIC • WELL COOKED, MASHED & SEMISOLID FOODS SHOULD BE GIVEN 25 FOODS TO BE USED IN RESTRICTED AMOUNTS OR AVOIDED FOODS TO BE INCLUDED HIGH FIBRE FOODS LIKE- WHOLE GRAIN CEREALS, & THEIR PRODUCTS, e.g. Whole wheat flour, & cracked wheat, whole pulses & pulses with husk. Plenty of fluids like- juices & soups All raw vegetables & fruits Milk & milk based beverages Fried fatty foods Low fibre foods such as- refined cereals, & their products, dehusked pulses, well cooked fruits, vegetable in soft & puree form & potatoes Chemical irritants such as- condiments, Foods providing protein of high biological spices, pickles, relishes, chutneys, & value e.g.- eggs, fish, poultry strongly flavoured vegetables like cabbage, Plain gelatin based desserts, sugars, honey, capsicum etc. jam. 26 INFLUENZA Acute infection of short duration Spreads from person to person by contact inhalation of virus INCUBATION PERIOD-: 2 days with a range of 1-7 days. Sudden onset 27 SYMPTOMS Headache, lassitude, myalgia, shivering & fever Dry cough with sneezing or sore threat Depression Bronchitis and pneumonia are the most common & frequent complications of influenza. 28 DIETARY CONSIDERATIONS General principles of dietary treatment are followed for influenza patient 29 MALARIA CAUSATIVE ORGANISM PLASMODIUM P.VIVAX P. MALARIAE P. OVALE P. FALCIPARUM Is transmitted from human to human by the bite of female anopheles mosquitoes. Induced malaria occurs due to congenital transmission or transmission by blood transfusion. 30 SIGNS & SYMPTOMS Typical malarial attacks show sequentially over 4-6 hrs. Shaking chills, fever to 41C or higher & the sweating stage. Fatigue, headache, diziness, GI symptoms, myalgia, arthalgia, backache & dry cough. 31 DIETARY MANAGEMENT Same as for fever. 32 33 CHRONIC FEVER- TUBERCULOSIS Is a chronic infectious disease Major cause of illness & death in the underdeveloped countries Caused by a bacteria Mycobacterium tuberculosis. MALNUTRITION CAUSE-: POVERTY & POOR SANITATION IGNORANCE INFECTION UNHYGENIC LIVING CONDITIONS 34 CAUSATIVE ORGANISM-: The bacteria most affects the lungs, leading to pulmonary tuberculosis. Infection may be localized in other organs like- lymphnodes or kidneys or may be generalised. Small, non-motile, aerobic organism Gram positive 35 DEVELOPNENT OF DISEASE LYMPH NODES SPREAD THROUGH BLOOD STREAM PULMONARY ALVEOLI TRANSPORT SECONDARY LESIONS DEVELOP INVADE & REPLICATE PRIMARY SITEGHON FOCUS IN LUNGS EFFECTS ALL PARTS MYCOBCTERIUM TUBERCULOSIS 36 37 TRANSMISSION TRANSMISSION AIR MTB INFECTION COUGH, SNEEZE ASYMPTOMATIC SALIVA OF INFECTED PERSON 38 RISK FACTORS People with silicosis have an approximately 30-fold greater risk for developing TB. SILICON RISK OF TB IRRITATE RESPIRATORY SYSTEM IMMUNE RESPONSES BLOCKAGE LYMPHATIC VESSEL DEPOSITS Persons with chronic renal failure and also on hemodialysis have an increased risk. 39 Persons with diabetes mellitus have a risk for developing active TB that is two to four times greater than persons without diabetes mellitus, and this risk is likely to be greater in persons with insulin-dependent or poorly controlled diabetes. Low body weight is associated with risk of tuberculosis as well. Twin studies in the 1940s showed that susceptibility to TB was heritable. 40 Wasting of tissues, exhaustion, cough, expectoration, & fever Acute phase- high fever, increased circulation & respiration Chronic phase- low grade fever, high metabolic rate Loss of appetite, pain in chest, fatigue, weight loss, night sweats, & a persistent, worsening cough Lymphnodes & kidneys can also be affected Increased catabolism of tissue proteins Increased loss of body fluids 41 42 DAIGNOSIS Diagnosis relies on radiology (commonly chest X-rays), a tuberculin skin test, blood tests, as well as microscopic examination and microbiological culture of bodily fluids. 43 Refampicin, isoniazid, pyrazinamide, & ethambutol are the drugs used These drugs are supplied free to the patients Treatment lasts for a minimum period of nine months Rest, antibiotic therapy & fresh air along with nourishing food. Social contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in (extensively) multi-drug-resistant tuberculosis. Prevention relies on screening programs and vaccination, usually with Bacillus CalmetteGuérin vaccine. 44 DIETARY MANAGEMENT Objectives of dietary management are-: To reduce mortality by providing nutrients required by the body’s immune mechanism To control weakness & loss of weight To accelerate convalescence 45 ENERGY-: Energy needs are increased to minimize weight loss Energy intakes are increased by 300500kcal/day PROTEIN-: Increase the protein intake Protein foods of high biological value should be included About 1.2-1.5 of protein/kg body weight/day must be included 46 CARBOHYDRATES & FAT-: Enough carbohydrate is required to meet the energy Abundant carbohydrate help in protein sparing action Too much fat should be avoided MINERALS-: Liberal amount of Ca should be included in the diet. Fe supplements should be given. VITAMINS-: Liberal amount of vitamins should be provided. Diet should provide as much as retinol as possible. Additional amount of ascorbic acid is recommended 47 Good amount of vitamin D is included. B- complex vitamins need also increase. Provide supplements of vitamin B-6 & folate. DIET & FEEDING PATTERN-: A high protein, high energy, full fluid diet is given. Meals should be simple, easily digestible, well prepared & tempting Force feeding is harmful Too much fat should be avoided. All pulses should have a cereal-pulse combination Cheap sources of vitamin C must be given Seasonal vegetables must be given. 48 49 50 Acute illnesses are those that will eventually resolve without any medical supervision (such as colds and teething). Chronic illnesses are more serious illnesses that require medical supervision (like Tuberculosis or Cancer). An Acute illness typically will "run its course” A Chronic illness is one that requires medical supervision. Usually, medicines for acute illnesses are regulated as OTC (over-the-counter) drugs. . Usually, medicines for chronic illnesses are regulated as Prescription Only. 51 TYPHOID TUBERCULOSIS METABOLIC RATE INCREASES TO A GREAT EXTENT. BMR INCREASES BUT IS NOT AS HIGH AS IN TYPHOID. HIGH GRADE FEVER. LOW GRADE FEVER. CAUSATIVE ORGANISMSALMONELLA TYPHOSA CAUSATIVE ORGANISMMYCOBACTERIUM TUBERCULOSIS INTESTINAL DISEASE IT IS A DISEASE OF LUNGS. ENERGY INCREASES TO 10-20%. INCREASES ABOUT- 300500KCAL/DAY. PROTEIN- 1.5- 2g/ kg body wt PROTEIN- 1.3- 1.5g/ kg body wt 52 53