All about Bacterial Infections Caused by SALMONELLA —

• TYPHOID FEVER with diagnosis Treatment Signs and symptoms

Salmonella typhi and Salmonella paratyphi cause en­teric (typhoid) fever. Typhoid fever is a systemic disease characterized by fever and abdominal pain.

Bacterial Infections Caused bySALMONELLA — TYPHOID FEVER

SALMONELLA INFECTIONS TYPHOID FEVER

• Salmonella typhi and Salmonella paratyphi cause en­teric (typhoid) fever.
• Typhoid fever is a systemic disease characterized by fever and abdominal pain.
• The mesenteric lymph nodes and Peyer’s patches are enlarged.
• Incubation period is 3 – 21 days.

Signs and symptoms TYPHOID FEVER

• There is a prodrome of headache, anorexia, cough, weakness, hr a , muscle pains.
• There is prolonged fever in range of 101 – 104°F. There are gastrointestinal symptoms – pain, diar­rhoea, and constipation.
• There are rose spots / rashes, hepatosplenomegaly, epistaxis, and relative bradycardia.
• The rash appears at the end of first week and disap­pears in a few days.
• ‘The patient may go into delirium.
• Late complications occur in third or fourth week, like intestinal perforation and gastrointestinal haemorrhage.
• Rare complications are pancreatitis, hepatic abscess, endocarditis, pericarditis, orchitis, hepatitis, menin­gitis, nephritis, pneumonia, arthritis and parotitis.
• Relapse rate is high.
• Incidence of carriers is also high.

Diagnosis of TYPHOID FEVER

• is by culture, during the first week of infec­tion.
• The disease is marked initially by a fever up to 104° F for about 7 days, followed by a flat, rose-colored, fleeting rash, generalized lymphadenopathy, abdominal pain, anorexia, and extreme exhaustion as the bacteria spread through the bloodstream.
• Paratyphoid, pneumonia, dysentery, meningitis, smallpox, and appendicitis are among the differential diagnoses.

• The best means of providing bacterial confirmation is through bone marrow culture.

• Diagnostic points of value are the presence of rose spots, splenomegaly, leukopenia, the Widal serological test result, blood culture, and examination of feces for the presence of the causative organism.
• Damage to the liver and spleen is commonly seen.
• About 14 days after the infection begins, internal bleeding usually develops as the result of gastrointestinal ulcers, and this may lead to hypovolemic shock.
• The Widal test is a serological test for febrile aggluti­nins.

Treatment of TYPHOID FEVER :

• Chloramphenicol – 2-3 g / day
• Ampicillin – 1 g 6 hrly
• Ciprofloxacin 500 mg BD for 10 days
• Ofloxacin 800 mg in divided doses BD for 3 days
• Ceftriaxone 1 to 2 gm IV for 2 weeks.

SHIGELLAE

• Shigellae are Gram-negative bacilli of enterobacteriaceae. It causes acute infectious inflam­matory colitis or bacillary dysentery.
• it can be spread also by vomitus and oral secretions during the acute stage.

• The disease is most commonly transmitted through water or food contaminated by human feces, but

• Typhoid fever is caused by Salmonella typhi, gram-negative bacteria that invade the walls of the ileum and colon and then gain access to the bloodstream.
• Shigellosis presents with fever, bloody or watery di­arrhoea with recovery in a few days or weeks.

Treatment of TYPHOID FEVER

• Dexamethasone is administered a few minutes before antibiotics are given in patients with shock or decreased levels of consciousness

• The disease is treated with ciprofloxacin for 10 days.
• Oral rehydration therapy
• Fluroquinolones like Ciprofloxacin,
• and Ofloxacin for 1 to 3 days.
• Azithromycin,
• Cefixime
• Ampicillin
• Trimethoprim – Sulphamethoxozole.