L15- GI Infections VI (inflam. diarrhea, bacteria) Flashcards
list the types of Salmonella, associated species, and what they cause
Typhoidal:
- typhoid / paratyphoid fever
- S. typhi, S. paratyphi A/B/C
Non-Typhoidal:
- gastroenteritis / food poisoning
- other Salmonellas
list the three important Salmonella microbial features
- Gram(-) rods
- motile
- non-lactose fermenter
Salmonella spp. typing depends on….
- O Ag, cell wall
- H Ag, flagella
- Capsular Vi (virulence) Ag
Salmonella has (1) property, therefore it needs (high/low) inoculation dose
1- acid labile
2- large dose (many destroyed in stomach)
Typhoid Salmonella reservoir is (1), mainly transmitted via (2)
Non-typhoid reservoir is (3), mainly transmitted via (4)
1- humans
2- person-to-person transmission
3- humans + animals
4- contaminated foods (poultry, dairy)- note person-to-person is less common
list the clinical manifestations of Salmonellosis and indicate the associated species
Gastroenteritis: S. typhimurium, S. enteritidis, S. newport
Septicemia / Bacteremia: (rare) S. cholerasuis
Enteric / Typhoid Fever: S. Typhi
list the complications of Salmonellosis
-CVS, CNS, pulmonary, hepatobilliary involvement
- reactive arthritis
- osteomyelitis
Salmonellosis –> gastroenteritis:
- (1) species
- (2) main infection description
- worse effects in (3) patients and invasive in (4) patients
- (5) is a common associated symptom
1- S. typhimurium, S. enteritidis, S. newport 2- self-limiting diarrhea 3- young, elderly 4- children, cancer, SCD Pts 5- vomiting
Salmonellosis –> septicemia:
- (1) species / transmission
- defining condition in (2) patients
- (3) clinical presentation
1- any species found in contaminated food / water
2- AIDS
3- fever/chills, oliguria, tachycardia, tachypnea, vomiting, diarrhea
list the risk factors for Salmonella Septicemia (in order of most importance)
1a) age extremes, immunosuppression, malignancy, congenital immune defects
1b) other predisposing co-morbidities (includes liver disease, hemoglobinopathies)
2) alteration to GIT by suppression of gastric acid (antacids) or antibiotics
Salmonella pathogenesis:
- (1) route of entry
- (2) mediates attachment
- (3) and (4) aid in intracellular survival, where they are contained in (5)
(similar to Shigella, although replication in vacuoles, not cytoplasm)
1- paracellularly, M-cell endocytosis
2- SPI-1 (salmonella pathogenicity Island-1)
3- SPI-2
4- T3SS (type 3 secretion system)
5- SCV (salmonella containing vacuoles)
describe Salmonella pathogenesis (gastroenteritis)
1) ingestion
2) attaches to SI
3) invades M cells (Peyer’s patches) + enterocytes (PAI encoded)
4) survive/replicate w/in vacuole (PAI encoded)
5) transports across cytoplasm
6) release into blood/lymph
Enteric fever:
- (1) organisms/spp.
- (2) reservoir
- (3) geographic areas
(Typhoid / Paratyphoid fever)
1- S. typhi, S. paratyphi A/B
2- humans (no animals)
3- Asia, Mexico, India (travelers to those places)
describe Salmonella pathogenesis (Typhoid/Paratyphoid fever)
1) blood stream
2) macrophage involvement
3) transports to liver, spleen, bone marrow
4) colonization in gall bladder
5) second bacteremia
6) replication in bile
7) re-enters intestines
Enteric Fever:
-(1) is required and (2) is occasionally seen before diagnostic testing
-(3) and (4) are used in diagnostic testing
1- h/o travel to endemic areas
2- transient macular rash (rose-colored) on trunk
3- examination of blood: anemia, leukopenia, absence of eosinophils
4- blood culture –> S. typhi isolation (needs many samples)