ENTERIC FEVER Flashcards

1
Q

What is enteric fever?

A

A communicable disease encompassing typhoid and paratyphoid fevers caused by Salmonella typhi and Salmonella paratyphi A B

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2
Q

What are typhoidal Salmonella species?

A

Salmonella typhi and Salmonella paratyphi A B

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3
Q

What are non-typhoidal Salmonella species?

A

Other serotypes of Salmonella enterica such as Salmonella typhimurium

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4
Q

What is the reservoir of infection for enteric fever?

A

Humans are the only reservoir except for S. paratyphi C

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5
Q

How is enteric fever transmitted?

A

Fecal-oral route often through contaminated food and water; rarely person-to-person.

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6
Q

What is the incubation period of enteric fever?

A

10-14 days but it can range from 6 to 30 days depending on dose and host factors.

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7
Q

What is the infective dose of Salmonella typhi?

A

Usually 10^7 but it can be as low as 10^3 in vulnerable hosts.

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8
Q

What are the systemic features of enteric fever?

A

Involves the reticuloendothelial system intestinal lymphoid tissue

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9
Q

What are the clinical stages of enteric fever?

A

First week: Fever headache

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10
Q

What are key complications of enteric fever?

A

Intestinal hemorrhage and perforation jaundice

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11
Q

What are the risk factors for enteric fever?

A

Age (school-age children young adults)

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12
Q

What are the main diagnostic methods for enteric fever?

A

Clinical suspicion blood culture (1st week)

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13
Q

What is the Widal test?

A

A serological test detecting O and H antibodies to S. typhi widely used but with poor specificity and sensitivity.

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14
Q

What is the IDL Tubex test?

A

An immunochromatographic test detecting IgM to S. typhi O antigens providing early diagnosis with ~90% sensitivity.

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15
Q

What is the gold standard for diagnosing enteric fever?

A

Blood culture despite its low sensitivity due to low bacteremia and prior antibiotics.

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16
Q

What are the first-line treatments for enteric fever?

A

Fluoroquinolones like ciprofloxacin with ceftriaxone and azithromycin as alternatives.

17
Q

Why is chloramphenicol no longer used for enteric fever?

A

Widespread resistance has rendered it obsolete as a first-line therapy.

18
Q

What is the role of cholecystectomy in chronic carriers of S. typhi?

A

Considered if antibiotics fail to eradicate gallbladder colonization.

19
Q

What are preventive measures for enteric fever?

A

Safe water proper sanitation

20
Q

What are the two types of vaccines for typhoid fever?

A

Injectable polysaccharide vaccine (Typhim Vi) and live oral vaccine (Typhoral).

21
Q

What is the efficacy of injectable typhoid vaccine (Typhim Vi)?

A

50-70% with protection lasting 2 years.

22
Q

What is the efficacy of the live oral typhoid vaccine (Typhoral)?

A

50-70% with immunity starting 2-3 weeks after administration and lasting 7 years.

23
Q

Who should receive the live oral typhoid vaccine?

A

Recommended for travelers to high-risk areas but contraindicated in children under 5 and immunocompromised individuals.

24
Q

What are common differential diagnoses of enteric fever?

A

Malaria dengue

25
Q

What is the case fatality rate of enteric fever?

A

Reduced to ~2% globally with antibiotic use but it remains higher in endemic areas.

26
Q

What are the epidemiological hotspots for enteric fever?

A

South Asia sub-Saharan Africa (1000/100

27
Q

What is the significance of rose spots in enteric fever?

A

A rash observed in light-skinned individuals during the second week indicative of S. typhi infection.

28
Q

What is the importance of bone marrow culture in enteric fever?

A

Has the highest sensitivity (>90%) but is rarely used due to associated risks.