160 Salmonella Flashcards
Salmonella serotypes that is restricted to human host
Salmonella typhi and salmonella paratypi
How does Salmonella infection begin?
Ingestion contaminated food or water
Best characterize regulatory system of the salmonella that trigger outer membrane so as to resist microbicidal activities
PhoP/PhoQ
Hallmark feature of enteric fever
Fevr and abdominal pain
Incubation period of S. Typhi
10-14 days. Range from 5 to 21 days
Most prominent symptom of Salmonellosis
Fever 38.8 to 40. 5 Celsius. Fever 101.1 to 104.9 Fahrenheit
Faint salmon colored blanching maculopapilar rash located on trunk and chest during the first week of Salmonellosis
Rose spots, present in 30% of patient and resolves in 2-5 days
When does GI bleeding and intestinal perforation occur
3rd and 4th week of illness
How does intestinal perforation and GI bleeding occur in Typhoid fever
Hyperplasia ulceration and necrosis of the ileocecal Peyers patches at the initial site of salmonella infiltration
Neuropsychiatric symptoms in Typhoid fever
Muttering delirium, Coma vigil, Picking at bedclothes or imaginary objects
How long is S. Typhi excreted in the feces
Up to 3 months
Chronic carriage in Typhoid fever is common to what subset of people
Women, infants, persons with biliary abnormalities or concurrent bladder infection
What bladder infection occurs together with S. Tyohi
Schistosoma haematobium
How does S. Typhi stay in the gallbladder
Forming biofilms on gallstones and invading gallbladder epithelial cells
Chronic Typhoid carriage is associated with what cancer
Gallbladder cancer
What is the sensitivity of blood culture for salmonellosis
40-80%
Has 80% sensitive for Typhoid fever and is not affected by 5 days of prior antibiotics
Bone marrow culture
When does stool culture become positive for Typhoid fever
3rd week of infection in untreated patient
Most effective class of antibiotics against salmonella
Fluoroquinolones: Ciprofloxacin
Empirical treatment for enteric fever
Ceftriaxone, Azithromycin
Antibiotics therapy for Typhoid fever. Fully susceptible. Optimal
Ciprofloxacin, Azithromycin
Antibiotics therapy for Typhoid fever. Fully susceptible. Alternative treatment
Amoxicillin, Chloramphenicol, TMP SMX
Antibiotics therapy for Typhoid fever. Multiple drug resistance. Optimal treatment
Ceftriaxone, Azithromycin
Antibiotics therapy for Typhoid fever. Multiple drug resistance. Alternative treatment
Ciprofloxacin
Antibiotics therapy for Typhoid fever. Quinolone resistant. Optimal treatment
Ceftriaxone
Azithromycin
Antibiotics therapy for Typhoid fever. Quinolone resistant. Alternative treatment
High dose Ciprofloxacin 750 mg BID or 400 mg q8hrs x 10-14 days
How long should therapy be administered in patients with continued symptoms of enteric fever
10 days or for 5 days after fever resolves
How are chronic carrier of salmonella be treated
4 weeks of oral Ciprofloxacin or other fluoroquinolones
What are the two commercially available vaccines? Oral? Minimum age for vaccination
Ty21a - - oral; at 6 years old. Vi CPS - - parenteral; at 2 years old
Live attenuated S Typhi Vaccine. How is it administered
Ty21a. Day 1,3,5,7 then full 4 revaccinatiob every 5 years
Parenteral Typhoid vaccine. Consist of purified polysaccharide from bacterial capsule. How is it given
Vi CPS. Single dose. Booster every 2 years
Can cause pseudoappendicitis
NonTyphoidal salmonellosis
In NTS, how Ling can the stool remain positive
4-5 weeks
Commonly affected area of salmonella osteomyelitis
Femur, Tibia, Humerus, Lumbar
When is salmonella osteomyelitis commonly seen in association with?
Sickle cell disease
How is patient with NTS and HIV treated
1-2 week IV antibiotics then 4 weeks oral therapy with fluoroquinolones
How is NTS endocarditis or arteritis treated?
6 weeks IV beta lactams
Antibiotics therapy for NTS. Preemptive treatment
Ciprofloxacin
Antibiotics for NTS. Severe gastroenteritis
Ciprofloxacin, TMP SMX, Amoxicillin,
Ceftriaxone
Antibiotics therapy for NTS. Bacteremia
Ceftriaxone, Ciprofloxacin
Antibiotics therapy for NTS. Endocarditis and arteritis
Ceftriaxone, Ciprofloxacin, Ampicillin
Antibiotics therapy for NTS. Meningitis
Ceftriaxone, Ampicillin
