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Infectious Diseases > Typhoid Fever > Flashcards

Typhoid Fever Flashcards

1
Q

Typhoid Fever

Bacteria causing enteric fever

A
  • Salmonella typhi
  • Salmonella paratyphi A,B,C
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2
Q

Typhoid Fever

Bacteria causing typhoid

A

Salmonella typhi

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3
Q

Typhoid Fever

non typhoid salmonella bacteria causes

A

gastroenteritis

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4
Q

Typhoid Fever

Mode of transmission

A

feco- oral

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5
Q

Typhoid Fever

Source of transmission

A

humans

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6
Q

Typhoid Fever

Infective dose

A

10^5 organisms

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7
Q

Typhoid Fever

3 main antigenic factors of salmonella paratyphi

A
  • O- Somatic Ag
  • Vi- encapsulation Ag
  • H- flagellar Ag
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8
Q

Typhoid Fever

Incubation period

A

5-21 days

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9
Q

Typhoid Fever

Pathogenesis

A
  • Bacteria enters through oral route
  • Escape the acidic stomach barrier
  • Invade the ileum mucosa
  • Phagocytosed but survive the phagocytosis
  • Crried to Lymph nodes and multiply there
  • Enter the blood stream and cause primary bacteremia
  • Reach- liver, GB, Spleen, Kidney, Bone marrow
  • Multiply and cause Secondary bacteremia
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10
Q

Typhoid Fever

Invading site in human

A

ileum

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11
Q

Typhoid Fever

Sx during the 1st week

A
  • Slow rising temp w relative bradycardia
  • Malaise
  • headache (mainly frontal)
  • cough
  • Coated tongue
  • constipation
    • blood culture
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12
Q

Typhoid Fever

Sx during the second week

A
  • High fever ( Step ladder)
  • Diarrhea
  • rose spots in lower chest and abdomen
  • Hepatosplenomegaly
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13
Q

Typhoid Fever

Sx during the third week

A
  • intestinal hemorrhage
  • Intestinal perforation and septicemia
  • Diffuse peritonitis
  • Encephalitis
  • Metastatic abscess
  • cholecystitis
  • Endocarditis
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14
Q

Typhoid Fever

Labs during first, second, third week

A
  • First week- blood culture +
  • Second week - Stool culture +, widal + for O and H Ab
  • Third week- Urine culture +
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15
Q

Typhoid Fever

Test done irrespective of the time

A

Blood culture

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16
Q

Typhoid Fever

DDs

A

Appendicitis

17
Q

Typhoid Fever

Similarities with appenidicits

A
  • RIF Pain
  • Coated tongue
  • Fever
18
Q

Typhoid Fever

Step ladder fever is seen during

A

Mainly second week but can be seen during the first week as well

19
Q

Typhoid Fever

Complications

A
  • Some become chronic carriers
  • Intestinal perforation
  • Intestinal hemorrhage
  • Rarely Periosteitis, myocarditis, pneumonia
  • Bone marrow suppression
20
Q

Typhoid Fever

Chronic carriers carry the bacteria in the

A

Mainly the GB, sometimes the Kidney

21
Q

Typhoid Fever

How does the carriers spread the disease

A

Through excreta time to time

22
Q

Typhoid Fever

Best Ix

A

Bone marrow culture, Not done though

23
Q

Typhoid Fever

FBC

A

Can be normal. WBC reduced. Mainly neutrophils

24
Q

Typhoid Fever

Serology tests

A

SAT ( Standard agglutination tes, Widal test)

25
Q

Typhoid Fever

SAT

A
  • NOt done because of the low sensitivity and specificity
  • Targets O and H Ag
26
Q

Typhoid Fever

SAT test samples are best taken during

A

Acute and convalescent phases

27
Q

Typhoid Fever

Rx

A
  • Cefotaxime/ ceftriaxone
  • Ciprofloxacin
  • Co- amoxiclav
28
Q

Typhoid Fever

Why is chloramphenicol not given anymore

A

can further cause bone marrow suppression. Disease itself can cause BM suppression

29
Q

Typhoid Fever

Chronic carriers impose a problem in careers such as

A

Food handlers

30
Q

Typhoid Fever

Groups more prone to become chronic carriers

A
  • Female
  • Biliary abnormalities
  • Co- existing bladder schistosomiasis
31
Q

Typhoid Fever

How does chronic carriers spread the illness

A

Through urine and fecal excreta for >1 year

32
Q

Typhoid Fever

Why does chronic carriers carry the bacteria for more than one year in urine and feces

A

Due to the persistent infection in the GB and Kidney

33
Q

Typhoid Fever

Relative bradycardia

A

Usually in a fever, increase in body temp by one degree will increase the heart rate by 8- 10 bpm. But in typhoid fever HR will increase by ~ 5-6 bpm

34
Q

Typhoid Fever

One difference which sets Typhoid fever sets apart from lepto and typhus

A

Typhoid will have altered bowel habits. First week will have constipation and then second week will have diarrhea

Infectious Diseases (7 decks)

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