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Wear particles in an isoelastic THR
Wear particles in an isoelastic THR
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Wear of TKR at 5 yrs
Wear of TKR at 5 yrs
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01 
 Ankle Fx with gross displacemement, needs urgent ORIF
02 
 The WorldOrtho Textbook
03 
 Oxford Handbook of Sports Medicine

Much more likely to die from MVA
Much more likely to die from MVA
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Lateral condylar Fx of lower humerus. Easily missed. Needs ORIF.
Lateral condylar Fx of lower humerus. Easily missed. Needs ORIF.
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Latest:
The Classical Clinical Picture of Typhoid Fever PDF Print E-mail
 
 
 
PART II DIAGNOSIS

CHAPTER 6 — THE CLASSICAL PICTURE OF TYPHOID FEVER
Figure 16 — Classical Picture of Typhoid
 
The classical clinical picture of typhoid fever is illustrated:

The incubation period is usually from 10-14 days, but it may vary from 7-21 days, and sometimes even less than 7 days. In the case of the paratyphoid fevers the incubation period is shorter than in typhoid.

There is a step ladder rise of temperature to about 104° F during the first week, a plateau during the second week, and a gradual fall during the 3rd and 4th weeks.

The pulse is classically slow and dicrotic, and the respirations between 20 to 30.

Examination of the patient shows a mentally confused patient, with a toxic facies, a coated tongue and a musty odour.

There may be rose spots of 1-2 mm diameter on the skin, and examination of the chest usually shows evidence of bronchitis with diffuse râles and rhonchi. The spleen is enlarged and soft, and there is often diffuse tenderness and a ‘doughy’ feel of the abdomen. There is often albuminuria, and the stools are ‘pea soup’ in consistency.

Blood culture is often positive for the typhoid bacillus in the first week, the Widal agglutination reaction of the serum raised in the second week, and stool and urine culture positive in the third week. There is often a leucopenia, and the diazo reaction of the urine is positive in over 90% of patients during the febrile phase of the illness.

Table VI — Main Symptoms on Admission
 
This table summarises the symptoms in 975 typhoid patients treated by the author. These are divided into the 240 research patients and the 735 subsidiary cases.




 
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