THYPOID FEVER Flashcards
- Gram-negative, non-spore-forming, facultatively anaerobic bacilli that measures 2-3um by 0.4-0.6 um
- produce acid on glucose fermentation, reduce nitrate and do not produce cytochrome oxidase A
Salmonella
Salmonella that doesn’t produces gas (H2S) on sugr fermentation
S. typhi
Mode of Transmission of Salmonella
- oral ingestion of an infectious dose
Invasion of salmonella occurs in ____, after ingestion, M cells may be the preffered portal of entry
terminal ileum
is transferred to monocytic cells and is trafficked to the reticulo-endothelial system, in a ____
- S thypi
- semi dormant state
S typhi seeds into the ___, ____ and ____ where it can reside and may be detected for months or years
- liver
- gallbladder
- bone marrow
Incubation period
5-21 days
First symptoms in the clinical course of salmonela
- diarrhea or constipation
Before 1 week signs and symptoms
- fever
- headache
- malaise
- anorexia
- myalgia
- arthralgia
- cough
- sore throat
After 1 week systemic toxemia occurs
- neuropsychiatric manifestation ( 1 psychosis, 2 confusions)
- coryza (inflammation of the nose
- cough
- sore throat
- chest pain
- nausea
- vomiting
- abdominal pain
Signs and symptoms resolves in
2-4 weeks
Early physical findings
- rash (rose spots)
+ faint, salmon colored, blanching maculopapular rash located primarily on the trunk and chest
+ usually in 1st week
+ resolves w/o a trace after 2-5 days - hepatosplenomegaly
- epistaxis
- relative bradycardia at the peek of high fever
Sever disease of Salmonella risk factors
- genetics
- immunosuppression
- acid suppression therapy
- previous exposure
- vaccination
- strain virulence
- inoculum
- choice of antibiotic therapy
Severe Disease of Salmonella results to
- GI bleeding and intestinal perforation - common in the 3-4 weeks of illness results to
- hyperplasia
- ulceration
- necrosis of the ileocecal Peyer’s patches at the initial infiltration site
DIAGNOSTIC TEST FOR THYPOID FEVER
- Widal test ( 1 - >5weeks)
- Bone Marrow (2-4 weeks)
- Urine culture (25%: 2-4 weeks; 10% 4-5 weeks)
- Feces culture ( 80%: 1-2 weeks; 50% 2-4 weeks; decreasing positivity (4-5 weeks)
- Blood culture (80-90%: 1-4 weeks)
