enteric fever

Question 1

Enteric fever (typhoid/paratyphoid) etiology?

Answer 1

Salmonella typhi and Salmonella paratyphi (types A, B & C)

Question 2

Pathophysiology of Enteric fever (typhoid/paratyphoid) ?

Answer 2

via the faecal-oral route (also in contaminated food and water)

Question 3

clinical features of Enteric fever (typhoid/paratyphoid) ?

Answer 3

relative bradycardia !!!!

fever

abdominal pain, distension

constipation:
although Salmonella is a recognised cause of diarrhoea, CONSTIPATION is more common in typhoid

gastrointestinal bleeding in the later stages of the diseas

rose spots: present on the trunk in 40% of patients, and are more common in paratyphoid
= Faget sign

typhoid = delirium/encephalitis

Question 4

inference between salmonella typhi / paratyphoid ?

Answer 4

ratyphoid is considered to be typically milder than typhoid and of shorter duration

Question 5

Possible complications include?

Answer 5

osteomyelitis (especially in sickle cell disease where Salmonella is one of the most common pathogens)

GI bleed

perforation - typically occur in the third week of illness

meningitis

cholecystitis

chronic carriage (1%, more likely if adult females)

Question 6

diagnosis of enteric fever ?

Answer 6

causes Leukopenia / eosinopenia

general lymphocytosis

Question 7

Travellers may be recommended WHAT BEFORE travelling to high risk areas ?

Answer 7

typhoid vaccine
VACCINATION NOT 100 PERCENT EFFECTIVE