SALMONELA/TYPHOID

Question 1

The mean incubation period for S. Typhi

Answer 1

10-14 days

• but ranges from 5-21 days

Question 2

The most prominent symptom in typhoid fever?

Answer 2

prolonged fever

Question 3

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?

Answer 3

Rose spots

Question 4

Complication of typhoid fever that most commonly occur in the third and fourth weeks of illness

Answer 4

Gastrointestinal bleeding (6%) and intestinal perforation (1%)

Question 5

Chronic carriage is more common among

Answer 5

• Women
• Infants
• Persons who have biliary abnormalities or concurrent bladder infection with Schistosoma haematobium.

Question 6

TRUE OR FALSE: Chronic carriage is associated with an increased risk of gallbladder cancer

Answer 6

TRUE

Question 7

Stool cultures can become positive during what week of infection in untreated patients.

Answer 7

3rd week

Question 8

The definitive diagnosis of enteric fever requires

Answer 8

isolation of S. Typhi or S. Paratyphi from blood, bone marrow, other sterile sites, rose spots, stool, or intestinal secretions

Question 9

Patients who develop chronic carriage of Salmonella can be treated for _ weeks

Answer 9

4 weeks (28 days)

Question 10

It is an oral live attenuated S. Typhi vaccine given on days 1, 3, 5, and 7

Answer 10

Ty21a

Question 11

The most effective class of agents for the treatment of drug-susceptible typhoid fever

Answer 11

fluoroquinolones

Question 12

gram-negative, non-spore-forming, facultatively anaerobic bacilli

Answer 12

Salmonella

Question 13

Infectious dose of salmonella

Answer 13

200 CFU to 10^6 CFU

Question 14

Empiric antibiotic therapy for Enterif fever?

Answer 14

Ceftriaxone 2g IV OD for 10-14 days
Azithromycin 1g tab OD x 5 days

Question 15

Ceftriaxone-resistant S. Typhi infection should be treated empirically with

Answer 15

Meropenem 1g IV q8 for 10-14 days or
Azithromycin 1g tab OD x 5 days

Question 16

Drug of choice for eradication of carriage?

Answer 16

Ciprofloxacin 500-750mg BID x 28 days

Question 17

If the patient is a chronic carrier but susceptibility studies showed fluoroquinolone resistance, what is the alternative treatment option?

Answer 17

Amoxicillin 2g tab PO x 28-42 days

Question 18

TRUE OR FALSE: Severe enteric fever remains one of the few indications for glucocorticoid treatment of an acute bacterial infection

Answer 18

TRUE

Question 19

It is a parenteral vaccine consisting of purified Vi polysaccharide from the bacterial capsule

Answer 19

Vi CPS
* given in a single dose
* with a booster every 2 years
* minimal age for vaccination is 2 years for Vi CPS

Question 20

What is the treatment of enteric fever in cases where anatomic abnormality (e.g., biliary or kidney stones) is present?

Answer 20

both antibiotic therapy and surgical correction.