Case 43: Fever and malaise in a traveller from India

Question 1

What are the symptoms of salmonella typhae infection?

Answer 1

Few days after returning from trip to endemic region

Fever and malaise

Anaemia and splenomegaly

Pinkish papules “rose spots” on upper abdomen

Developed into sparse maculopapular rash

Question 2

How is growth of salmonella typhae indicated in blood cultures?

Answer 2

By the incubator sensor detecting an increased labeled CO2 produced by metabolising bacteria

Question 3

What will a gram stain of salmonella typhae show?

Answer 3

Gram negative rods

Question 4

What is the colonial morphology for Salmonella typhae on MAC inoculated with a faecal sample?

Answer 4

Dark pink colonies

Lactose fermenting

Question 5

Can salmonella typhae grow on MAC?

Answer 5

Yes

Question 6

Can salmonella typhae grow on CIN?

Answer 6

No

Question 7

Which antibiotics are salmonella typhae susceptible to?

Answer 7

Ampicillin

Ciprofloxacin

Chloramphenicol

Question 8

What is the colonial morphology for Salmonella typhae on HBA inoculated with a blood culture?

Answer 8

Grey shiny colonies

Big

No pigment

Question 9

What is the colonial morphology for Salmonella typhae on MAC inoculated with a blood culture?

Answer 9

Cloudy shiny colonies

Lactose non-fermenters

Question 10

What fever does salmonella typhae cause?

Answer 10

Typhoid fever

Question 11

What is the Gram morphology for salmonella typhae?

Answer 11

Gram negative rods

Question 12

How could salmonella typhae be further characterised?

Answer 12

Look for O and H antigens - also look for virulence gene