Typhoid আমাদের দেশে খুব কমন। আবার খুব কমন না হলেও আমরা diagnosis হিসেবে typhoid fever খুব কমনলি labelling করি।

salmonella different species different symptoms করে। কোনটা gastroenteritis কোনটা enteric fever etc.

Pathogenesis :(salmonella in general)

Infected food/water→→stomach →small gut→ileum and caecum→→enter into epithelial cell→→hypertrophy of ileal lymph node and payers patch(constipation করে)(1st week)→→salmonella in submucosal space→→engulfed by macrophage →via mesenteric lymph node and lymphatic(thoracic duct)→→enters into Blood circulation for transient period(Bacteremia- এসময় blood culture + আসতে পারে)→→reticuloendothelial system (spleen,lymph node) engulf the bacteria and destroy→→if bacteria is not destroyed by macrophage /reticuloendothelial system they are released again into the blood→→bacteremia(Fever))→via blood they can deposit into brain((meningitis/neuritis/psychosis))/liver/ cardiac /kidney/bone Narrow(osteomylitis)/intestine(payers patch)→→more bacteria in intestine→more inflammation →→diarrhoea(2nd week)/ulcer in payers patches(3rd week) →perforation if untreated.

*liver থেকে gallbladder এ আসে। bile এর সাথে intestine এ যায়। stool এর সাথে pass হয়। এভাবে সে chronic charrier হিসেবে থাকতে পারে।

এভাবে যদি আমরা pathogenesis বুঝে পড়ি কোন stage এ কত সপ্তাহে কোন symptoms হয় এবং কী investigation করবো এটা আলাদাভাবে মুখস্থ করতে হবে না ইন শা আল্লাহ Raiyyan Tahsan. Date:26-01-2025 Sunday Time:8-25-55PM

• TC(1487).(56). General Medicine Department Case No (14): Presumed Treated Hypertension and Type 2 Diabetes with Possible Upper-GI Dyspepsia/Dysmotility and Cardiovascular Risk Management (1 Prescription + 0 Reports + 0 Supporting Images).5432
• TC(1486).(02). Dermatology Department Case No 107:- Suspected Superficial Dermatophytosis with Possible Coexisting Allergic Rhinitis: Clinical Diagnosis, Prescription Analysis and Evidence-Based Management (1PR+0RE+0IMG)4433
• TC(1485).(02). Dermatology Department Case No (106): Undifferentiated Genital Ulcer Disease with Associated Skin Rash and Generalized Weakness Suspected Syphilis versus Genital Herpes; Possible Secondary Bacterial Infection (1 PR+ 0RE + 0Img)7799
• TC(1484).(09).Obstetrics & Gynecology Case No 60:-High-Risk Pregnancy with History of Two Preterm Deliveries and Two Neonatal Deaths: Diagnosis, Drug Safety and Evidence-Based Management(1PR+0RE+0IMG)8090
• TC(1483).(09). Gynecology Department Case No. (59): Physician-Documented Mastitis with Fever — Possible Inflammatory or Bacterial Mastitis; Breast Abscess and Dengue Fever to Be Excluded (1Prescription + 0Reports + 0Images)0909