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Salmonella Typhi

Terms in this set (51)

Salmonella typhi is associated with what condition?
Systemic Typhoid(typhoid fever)
NT. Salmonella is associated with what condition?
Gastroenteritis
Shigella is associated with what condition?
Dysentery->Grossly bloody diarrhea
Yersinia enterocolitica is associated with what condition?
Gastroenteritis &
pseudoappendicitis
give some common charcteristics for :
GNB Enterobacteriaceae Strict Pathogens
Oxidase (-)*
Non-lactose Fermenting (white on MacConkey)**
Strict pathogens, cause invasive GI infections
Strict pathogens are called so bc?
cause invasive GI infections
How can you tell Salmonella typhi and friends apart from Campylobacter?
Oxidase (-)*
How can you tell Salmonella typhi and friends apart from the pathogenic E coli strains?
Non-lactose Fermenting
(white on MacConkey)**
Give some important characteristics of Salmonella enterica
Motile, peritrichous flagella*
Oxidase (-)**
Non-lactose fermenting***
H2S production****
Which strains cause Typhoid fever
Salmonella enterica serovar Typhi or Paratyphi
Non-typhoidal Salmonella NTS cause what condition?
Gastroenteritis
How can you tell Salmonella enterica apart from Shigella?
Shigella is non-motile
What separates Salmonella enterica apart from ALL other enteric bacteria?
H2S production****
Salmonella Course of Infection typically lasts how long?
4 days
Give the pathogenesis of Salmonella
Invades ileum epithilium & M cells via T3SS.

Avoids phagolysis due to capsule.

Can live intracellular in macrophages in Salmonella containing vacuole (SVC) via T3SS
What allows Salmonella to Invades the ileum epithilium & M cells?
T3SS
What allows Salmonella to Avoids phagolysis ?
capsule
What allows Salmonella to live intracellular in macrophages in Salmonella containing vacuole (SVC)?
T3SS
A disseminated Salmonella infection usually results in?
Gastroenteritis
(NonTyphoidal Salmonella)
A systemic infection usually results in?
Bacteremia
(Salmonella Typhi)
In a Salmonella infection the symptoms are?
host-meditated
Pt with Salmonella infection will experience high fever bc
Salmonella is invasive
pt comes to ER with a 3 day history of chills, HIGH fever, diarrhea. He had traveled to India and ate food from a street vender, he had not received an travel related vaccines. Most likely agent?
Salmonella Typhi
Salmonella Typhi transmission
HUMAN restricted,
fecal-oral route
Developing countries
Salmonella Typhi pathogenesis
Invade SI, but usually without inflammation.
Survive within macrophages and colonize liver, spleen, and can permanently live in gall bladder
How can Salmonella Typhi Re-colonize in the gut ?
it can do so via the gall bladder, later causing gastroenteritis.
pt has HIGH fever lasting 7 days
Headache/dementia
High monocytes in WBC
Hepato-splenomegaly
Rash "Rose Spots"
diarrhea
Doctor fears that the pt may become a Chronic carrier*
Death
Intestinal hemorrhage
typhoid fever
Salmonella Typhi
pt has HIGH fever lasting 7 days
Headache/dementia
High monocytes in WBC
Hepato-splenomegaly
Rash "Rose Spots"
diarrhea
Doctor fears pt:
Chronic carrier
Death
Intestinal hemorrhage
Treatment?
Fluoroquinolones*
What is the vaccine for Salmonella Typhi ?
Attenuated Vaccine (Vi capsule)
S.typhi replicates in?
reticulo-endothelial system*.
How long can S.typhi remain in gall bladder for without symptoms?
1-12 months
Typhoid Fever is aka
Enteric Fever
the symptoms of Typhoid Fever are due to?
host-meditated (LPS-TLR4)*
the term typhoid refers to?
bac in liver and spleen
the high and rapidly rising fever in Typhoid Fever is due to?
(++LPS)
Salmonella Typhi Complications include
Septic death (~30% if untreated)

Asymptomatic chronic carrier in gall bladder (~10%)
Six pts from the same family came to ER with 2 days of LOW grade FEVER, ab cramps, vomiting. They all ate undercooked turkey at thanksgiving, diagnosis?
Non-typhoidal Salmonella
Six pts from the same family came to ER with 2 days of LOW grade FEVER, ab cramps, vomiting. They all ate undercooked turkey at thanksgiving, pt have gastroenteristis. how should you treat?
Supportive threapy
Six pts from the same family came to ER with 2 days of LOW grade FEVER, ab cramps, vomiting. They all ate undercooked turkey at thanksgiving, pt have a systemic infection, how should you treat?
Ciproflaxcin**
(Fluoroquinolones)
If pts Salmonella infection doesn't improve with Ciproflaxcin then you should treat with?
3rd Generation Cephalosporin
Non-typhoidal Salmonella transmission?
Zoonotic Reservoir
(poultry, pigs, reptiles)****
OR
produce washed with contaminated water
VERY COMMON in USA ~ 2million/yr
name 2 common strains of Non-typhoidal Salmonella
S. Enteritidis and Typhimurium
Give the pathogenesis of Non-typhoidal Salmonella
Invade ileum Peyer Patch M cells & Intestinal Epithelial Cells
=
Cross to lamina propria & triggers inflammation
=
CMI activates macrophages, recruits PMN, controls infection, self-limiting diarrhea.
How does Non-typhoidal Salmonella present in a healthy host?
Gastroenteritis
Watery diarrhea,
Mild fever
Upper abdominal pain (may have vomiting)
How does Non-typhoidal Salmonella present in a CHILD/ELDERLY pt?
Severe Gastroenteritis =
high fever, watery/ scant bloody stools

GI + Bacteremia = high fever, septic symptoms

**Maybe PMN and blood in stools
Why is cell mediated immunity important in combating Non-typhoidal Salmonella
CMI activates macrophages, recruits PMN, controls infection
How does Non-typhoidal Salmonella present in immunocompromised pts?
1.Typhoid-LIKE disease :
high fever, septic symptoms

2.Meningitis = high fever, severe headache, etc
What is a complication of Non-typhoidal Salmonella especially in sickle-cell patients?
Osteomyelitis
What is a complication of Non-typhoidal Salmonella especially in HLA-B27 Patients?
Reiter's Syndrome
( Reactive Arthritis )
Name two general Non-typhoidal Salmonella Complications
Sepsis & Septic Arthritis***
Name how Salmonella appears on Hektoen (HE) Agar
black colonies
(bc Salmonella produces H2S)
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