Typhoid Fever Flashcards
Most important derangement in host defenses that leads to increased susceptibility to Salmomella infection
Decreased gastric acidity (more alkaline)
3 major antigenic determinants of Salmonella infection
Somatic O antigen
Surface Vi antigen
Flagellar H antigen
What happens during initial incubation stage
Salmonella invades reticuloendothelial system via lymphatics and disseminate to different organs - asymptomatic
Age group most susceptible to infection with Salmonella
Children < 1 year old
Hallmark of Salmonella infection
Fever >/= 5 days
Rash of Salmonella infection
Rose spots - salmon-colored blanching rash on the trunk and chest at the end of 1st wk up to after 2-5 days
Definitive diagnostic for Salmonella infection
Positive culture
Specimen for culture of Salmonella
Blood - not that sensitive
Bone marrow - higher sensitivity than blood, not affected by 5-day antibiotics
Stool - can be positive despite negative bone marrow culture, positive during 3rd wk
Other sterile sites like rose spots
Best way to obtain stool culture of Salmonella
Duodenal string test
Empiric treatment for Salmonella
Ceftriaxone, azithromycin
First line treatment for Salmonella infection
Fluoroquinolones
**if uncomplicated, may use chloramphenicol, ampicillin, TMP-SMX
Treatment for DCS Salmonella infection
Ceftriaxone or any 3rd gen cephalosporin, azithromycin, high-dose ciprofloxacin
Treatment for MDR Salmonella infection
Ceftriaxone or any 3rd gen cephalosporin
**MDR if resistant to chloramphenicol, ampicillin, and TMP-SMX
Duration of treatment for Salmonella infection
10 days or 5 days after fever lysis
May or may not give dexamethasone or steroids for Salmonella infection
May give dexamethasone for critically ill patients with shock and obtundation
