Enteric fever

Question 1

enteric fever caused by

Answer 1

salmonella spp.

Question 2

typhoid fever caused by

Answer 2

salmonella typhi (salmonella enterica)

Question 3

S.typhi transmission

Answer 3

ingestion of contaminated food (poultry, eggs, dairy)
fecal oral spread in children

Question 4

typhoid clinical picture

Answer 4

First week- malaise, abd pain, constipation, headache, loss of appetite
stepladder pattern fever
Second week- rose spots (pink macules on chest)
splenomegaly
Third week- intestinal bleeding and diarrhea.

Question 5

pathology of typhoid fever

Answer 5

1st wk- bacteremia
2nd wk- reticuloendothelial involvement, necrosis of liver foci, splenomegaly
3rd wk- peyer’s patch ulceration, intestinal bleeding, intestinal ulceration
4th wk- colonization in the gallbladder, chronic carrier state, chronic infection (joints, bones, meninges)

Question 6

lab diagnosis

Answer 6

1st wk- blood cultures are +ve and stool cultures are -ve
2nd & 3rd wk- stool cultures are +ve and blood cultures are -ve

Question 7

gold standard for typhoid diagnosis

Answer 7

bone marrow culture but highly invasive and expensive so not routinely used

Question 8

widal test?

Answer 8

detects antibodies against salmonella antigens

Question 9

treatment

Answer 9

ciprofloxacin
ceftriaxone

Question 10

complications

Answer 10

GI bleeding
bronchitis, pneumonia
jaundice, hepatitis
myocarditis, endocarditis
anemia
encephalopathy, seizures, meningitis