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What is another name for enteric fever?
What is another name for enteric fever?
Typhoid fever
Enteric fever is caused by which bacteria?
Enteric fever is caused by which bacteria?
What is the ratio of typhi infections to paratyphi infections?
What is the ratio of typhi infections to paratyphi infections?
10:1
Enteric fever is transmitted via the fecal-oral route.
Enteric fever is transmitted via the fecal-oral route.
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Enteric fever is most prevalent during the winter season.
Enteric fever is most prevalent during the winter season.
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Enteric fever can affect individuals of all ages.
Enteric fever can affect individuals of all ages.
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What is the first stage of pathogenesis for enteric fever?
What is the first stage of pathogenesis for enteric fever?
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What is the final stage of pathogenesis?
What is the final stage of pathogenesis?
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Which of the following is a clinical feature of Enteric fever?
Which of the following is a clinical feature of Enteric fever?
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Enteric fever is characterized by tachycardia.
Enteric fever is characterized by tachycardia.
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What is the name of the specific skin lesions that are often observed during the first week of enteric fever?
What is the name of the specific skin lesions that are often observed during the first week of enteric fever?
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Inflammation of the heart muscle can be a complication of Enteric fever.
Inflammation of the heart muscle can be a complication of Enteric fever.
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Enteric fever can lead to ______ of the brain.
Enteric fever can lead to ______ of the brain.
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Enteric fever complications include kidney failure.
Enteric fever complications include kidney failure.
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Osteomyelitis is a common complication of enteric fever.
Osteomyelitis is a common complication of enteric fever.
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Which of the following is considered the gold standard for diagnosing enteric fever?
Which of the following is considered the gold standard for diagnosing enteric fever?
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A decreased white blood cell count with more lymphocytes can be a sign of enteric fever.
A decreased white blood cell count with more lymphocytes can be a sign of enteric fever.
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The presence of rose spots on the trunk is a diagnostic sign for enteric fever.
The presence of rose spots on the trunk is a diagnostic sign for enteric fever.
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Which of the following is NOT a differential diagnosis for enteric fever?
Which of the following is NOT a differential diagnosis for enteric fever?
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Which of the following treatments is NOT a common recommendation for uncomplicated typhoid fever?
Which of the following treatments is NOT a common recommendation for uncomplicated typhoid fever?
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Which of the following antibiotics is commonly used to treat uncomplicated typhoid fever?
Which of the following antibiotics is commonly used to treat uncomplicated typhoid fever?
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Ceftriaxone is a recommended antibiotic treatment for severe typhoid fever.
Ceftriaxone is a recommended antibiotic treatment for severe typhoid fever.
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Gatifloxacin is only recommended for treating mild cases of typhoid.
Gatifloxacin is only recommended for treating mild cases of typhoid.
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Enteric fever typically leads to a good prognosis.
Enteric fever typically leads to a good prognosis.
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What is one of the main factors that determines the prognosis in Enteric fever?
What is one of the main factors that determines the prognosis in Enteric fever?
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Chronic carriers of enteric fever can excrete the bacteria for over 3 months.
Chronic carriers of enteric fever can excrete the bacteria for over 3 months.
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Which of the following is NOT a key prevention strategy for enteric fever?
Which of the following is NOT a key prevention strategy for enteric fever?
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The TAB vaccine is still commonly used for typhoid fever.
The TAB vaccine is still commonly used for typhoid fever.
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The Typhoid Vi Polysaccharide vaccine is recommended for children under 2 years of age.
The Typhoid Vi Polysaccharide vaccine is recommended for children under 2 years of age.
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The Typhoid Conjugate Vaccine is recommended for infants as young as 6 months old.
The Typhoid Conjugate Vaccine is recommended for infants as young as 6 months old.
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Study Notes
Enteric Fever
- Also known as "typhoid fever"
- Caused by Salmonella species:
- Salmonella enterica typhi
- Salmonella paratyphi A, B, C
- Ratio of typhi to paratyphi is approximately 10:1
- Transmission route: fecal-oral
- Incubation period: 7-14 days
Epidemiology
- Commonly occurs during summer months
- Affects patients of all ages, but children aged 2-15 are most susceptible
Pathogenesis
- Oro-fecal route
- M cells in the terminal ileum mucosa are infected
- Infection spreads to Peyer's patches
- Then to mesenteric lymph nodes
- Primary and secondary bacteremia follow
- Dissemination of infection throughout the body
- The reticuloendothelial system (RES) is affected, leading to secondary bacteremia.
Clinical Features
- High-grade fever
- Coated tongue
- Anorexia
- Vomiting
- Diarrhea or constipation
- Abdominal pain
- Headache
- Confusion or obtundation (altered mental status)
Examination
- Relative bradycardia
- Rose spots on the trunk (first week of illness)
- Hepatosplenomegaly (enlarged liver and spleen)
- Tympanic abdomen (abdomen sounds hollow upon percussion)
Complications
- Central nervous system (CNS): encephalopathy, delirium, ataxia, seizures
- Cardiovascular system (CVS): endocarditis, myocarditis, congestive heart failure
- Respiratory: pneumonia, empyema
- Gastrointestinal: complications related to the gastrointestinal tract
- Hepatobiliary: cholecystitis, hepatitis, hepatic/splenic abscess
- Genitourinary: urinary tract infection (UTI), renal abscess, prostatitis
- Bones: osteomyelitis, septic arthritis
Investigations
- Leukopenia with relative lymphocytosis
- Liver function test (LFT) abnormalities
- Blood cultures (gold standard)
- Agglutination tests (e.g., Widal test)
- Stool cultures
- Urine cultures
- Bone marrow cultures
- Serological tests (monoclonal antibodies)
- Polymerase chain reaction (PCR)
Differential Diagnosis
- Viral fever
- Malaria
- Tuberculosis
- Septicemia
- Brucellosis
- Leptospirosis
- Dengue
- Infectious mononucleosis
- Acute hepatitis
Treatment
- Adequate rest
- Hydration
- Antipyretics (fever reducers)
- Soft diet
- Antibiotic therapy:
- Uncomplicated typhoid: amoxicillin, fluoroquinolones, cefixime, azithromycin
- Severe typhoid: ampicillin (IV), ceftriaxone (IV), gatifloxacin
- Encephalopathy/shock: dexamethasone
Prognosis
- Factors influencing prognosis: patient age, general health status, presence of chronic carriers
- Chronic carriers: exhibit gall bladder infection and excretion of S. typhi for >3 months post infection.
Prevention
- Proper sewage and sanitation
- Hand hygiene
- Vaccination
Vaccination for Typhoid
- TAB vaccine (killed bacteria): obsolete
- Typhoid Vi polysaccharide vaccine (0.5 ml IM): 70% effective (for those >2 years old)
- Typhoid conjugate vaccine (TCV) (0.5 ml IM): 95% effective (for those 6 months-45 years old)
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Description
Dive into the details of enteric fever, commonly known as typhoid fever, including its causative agents, transmission routes, and epidemiology. This quiz covers the clinical features, pathogenesis, and examination details related to this significant infectious disease.
