Management of Pneumonia
The paper will give an overview of the microorganism and the disease and then go on to state ways in which the disease can be managed. For the purpose of this paper, I will discuss typhoid fever, a disease caused by rod-shaped, gram negative member of Kingdom Monera called Salmonella typhi. Slmonella typhi is a bacterium that is known to cause typhoid fever. It is aerobic and has a rod-shaped conformation (Bennington-Castro, 2018). By aerobic, I mean that Salmonella typhi requires oxygen to be able to survive. From the micrographs, the rod-shaped conformation of the bacteria can be seen as well as the flagella that help in their motion. ("Salmonella Bacteria | Electron Microscope Image from FEI", 2018). Figure 2: The cell wall of Salmonella typhi, a gram-negative bacterium.
(De Jong, Parry, van der Poll & Wiersinga, 2012). Typhoid fever is more common in the developing countries than in the industrialized countries. If one does not seek medical attention in the early stages of the disease, one is likely to enter into the advanced state of the disease where they become delirious and lie in the typhoid state, where one lies exhausted and motionless with their eye closed half-way (mayoclinic. org). This is also the time when most of the other life-threatening complications that are associated with typhoid start to manifest. There are people who may experience the signs and symptoms of the disease again about one or two weeks after the end of the fever. Management of typhoid requires concerted efforts from the individual.
There are other possible complications which include myocarditis, endocarditis, pancreatitis, pneumonia infections of the bladder or kidney, meningitis, and paranoid psychosis among others. According to the 2011 WHO guidelines on the management of typhoid, over 90% of typhoid patients can have their disease “managed at home with oral antimicrobial, minimal nursing care, and close medical follow-up for complications or failure to respond to therapy” (WHO, 2011, Kalra, Naithani, Melta & Swamy, 2003). For clinical management, it is important to do antimicrobial susceptibility testing. Patients of typhoid who have neurological complications should have their cerebrospinal fluid examined for evaluation of meningitis. In the management of typhoid fever, supportive measures are of crucial importance. Quinolones are very effective against the bacteria in vitro and therefore are more advantageous than the other antimicrobials that are used in treating typhoid fever.
Another effective drug for use in managing typhoid is ciprofloxacin because it does not result in carriers of the Salmonella typhi bacterium in the patients that use it (Kalra, Naithani, Melta & Swamy, 2003). However, resistance to this drug is also increasing, and especially so for Salmonella typhi. Therapy with ofloxacin appears to be simple and effective for treating MDR typhoid fever that is not complicated, but this is especially so when the strain that causes the disease is susceptible to nalidixic acid (Kalra, Naithani, Melta & Swamy, 2003). However, if a patient is infected with strains of Salmonella typhi that are resistant to quinolone, ofloxain may not be of much help and alternative or repeated treatment may be necessary. With azithromycin, a one gram daily dose that takes five days, the disease takes relatively longer for its symptoms to subside.
However, the main advantage with azithromycin and aztreonam is that both of them can be used in children and mothers that are either pregnant or nursing. Glucocorticosteroids can be used in treating severe typhoid as it reduces mortality in severe-typhoid fever patients. These are given for severe fever and, if the patient has profound sepsis, a dramatic response may come from them. Corticosteroids have no adverse effects whatsoever, but they have the potential to mask intestinal perforations (Brusch, 2018). Everydayhealth. com. Retrieved 13 April 2018, from https://www. everydayhealth. com/salmonella/guide/ Brusch, J. Retrieved 13 April 2018, from https://www. livestrong. com/article/556819-can-you-get-salmonella-from-undercooked- brownies/ De Jong, H. , Parry, C. , van der Poll, T. who. int. Retrieved 13 April 2018, from http://apps. who. int/medicinedocs/documents/s20994en/s20994en.
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