SALMONELA/TYPHOID Flashcards
The mean incubation period for S. Typhi
10-14 days
- but ranges from 5-21 days
The most prominent symptom in typhoid fever?
prolonged fever
Faint, salmon-colored, blanching, maculopapular rash located primarily on the trunk and chest evident at the end of the first week and resolves without a trace after 2–5 days in 30% of patients?
Rose spots
Complication of typhoid fever that most commonly occur in the third and fourth weeks of illness
Gastrointestinal bleeding (6%) and intestinal perforation (1%)
Chronic carriage is more common among
- Women
- Infants
- Persons who have biliary abnormalities or concurrent bladder infection with Schistosoma haematobium.
TRUE OR FALSE: Chronic carriage is associated with an increased risk of gallbladder cancer
TRUE
Stool cultures can become positive during what week of infection in untreated patients.
3rd week
The definitive diagnosis of enteric fever requires
isolation of S. Typhi or S. Paratyphi from blood, bone marrow, other sterile sites, rose spots, stool, or intestinal secretions
Patients who develop chronic carriage of Salmonella can be treated for _ weeks
4 weeks (28 days)
It is an oral live attenuated S. Typhi vaccine given on days 1, 3, 5, and 7
Ty21a
The most effective class of agents for the treatment of drug-susceptible typhoid fever
fluoroquinolones
gram-negative, non-spore-forming, facultatively anaerobic bacilli
Salmonella
Infectious dose of salmonella
200 CFU to 10^6 CFU
Empiric antibiotic therapy for Enterif fever?
Ceftriaxone 2g IV OD for 10-14 days
Azithromycin 1g tab OD x 5 days
Ceftriaxone-resistant S. Typhi infection should be treated empirically with
Meropenem 1g IV q8 for 10-14 days or
Azithromycin 1g tab OD x 5 days
Drug of choice for eradication of carriage?
Ciprofloxacin 500-750mg BID x 28 days
If the patient is a chronic carrier but susceptibility studies showed fluoroquinolone resistance, what is the alternative treatment option?
Amoxicillin 2g tab PO x 28-42 days
TRUE OR FALSE: Severe enteric fever remains one of the few indications for glucocorticoid treatment of an acute bacterial infection
TRUE
It is a parenteral vaccine consisting of purified Vi polysaccharide from the bacterial capsule
Vi CPS
* given in a single dose
* with a booster every 2 years
* minimal age for vaccination is 2 years for Vi CPS
What is the treatment of enteric fever in cases where anatomic abnormality (e.g., biliary or kidney stones) is present?
both antibiotic therapy and surgical correction.
Which of the following organisms cause enteric (typhoid) fever?
A) Salmonella Typhi and Salmonella Paratyphi
B) Salmonella Enteritidis and Salmonella Typhimurium
C) Escherichia coli and Vibrio cholerae
D) Shigella dysenteriae and Campylobacter jejuni
Answer: A
Rationale: Salmonella Typhi and Salmonella Paratyphi are restricted to human hosts and cause enteric (typhoid) fever.
How is typhoid fever most commonly transmitted?
A) Inhalation of contaminated droplets
B) Mosquito bites
C) Fecal-oral route through contaminated food and water
D) Direct skin contact
Answer: C
Rationale: Typhoid fever is primarily transmitted via the fecal-oral route, through ingestion of contaminated food or water.
What is the most prominent symptom of enteric fever?
A) Jaundice
B) Prolonged high fever
C) Severe vomiting
D) Hemoptysis (coughing up blood)
Answer: B
Rationale: The most prominent symptom of enteric fever is prolonged fever (38.8°C–40.5°C or 101.8–104.9°F).
What is the characteristic rash associated with typhoid fever?
A) Erythema nodosum
B) Petechial rash
C) Rose spots
D) Bullous rash
Answer: C
Rationale: Rose spots are faint, salmon-colored, blanching maculopapular rashes that appear primarily on the trunk and chest.
