23 Questions
What is the recommended treatment for osteomyelitis in adults with sickle cell disease?
Cephalosporin
What can cause 'pea soup' green diarrhea?
Bird droppings
What type of infection starts 1-3 weeks after exposure, includes fever, headache, and abdominal pain around the RLQ?
Typhoid Fever
Why are antibiotics not warranted in the treatment of gastroenteritis?
To allow the body to clear the infection naturally
Which antibiotic is NOT recommended for the treatment of Salmonella septicemia?
Amoxicillin
'Vi' interfering with lysosome-phagosome fusion is a characteristic of which bacterial infection?
Typhoid Fever
What is the characteristic of Salmonella that allows it to cause disease in patients on proton pump inhibitors?
It is acid labile and needs a high dose to cause infection
What is the key virulence factor of Salmonella Enteritidis that allows it to withstand the host's immune response?
The Vi antigen capsule
Which of the following is the primary source of Salmonella Typhi, the causative agent of typhoid fever?
The human host
What is the characteristic of Salmonella that allows it to be identified as a Gram-negative, non-lactose fermenting organism?
It is a Gram-negative, non-lactose fermenter that appears white on MacConkey's agar
What is the significance of the "candle being lit" symptom associated with Salmonella Enteritidis infection?
It refers to the inflammatory diarrhea and gastroenteritis caused by the infection
What is the most common cause of osteomyelitis in adults with sickle cell disease?
Sickle-shaped red blood cells
What is the recommended antibiotic treatment for Salmonella septicemia?
Chloramphenicol, ampicillin, amoxicillin, or trimethoprim-sulfamethoxazole
Which of the following is the primary source of Salmonella Typhi, the causative agent of typhoid fever?
Contaminated food or water
What is the key virulence factor of Salmonella that allows it to withstand the host's immune response?
Vi antigen interfering with lysosome-phagosome fusion
Why are antibiotics not warranted in the treatment of gastroenteritis?
Gastroenteritis is self-limiting and resolves without antibiotics
What is the characteristic of Salmonella that allows it to cause disease in patients on proton pump inhibitors?
Resistance to the acidic environment of the stomach
What characteristic of Salmonella allows it to be identified as a Gram-negative, non-lactose fermenting organism?
Its Gram-negative cell wall and inability to ferment lactose
What is the primary source of Salmonella Typhi, the causative agent of typhoid fever?
Infected chef aprons
What is the significance of the 'candle being lit' symptom associated with Salmonella Enteritidis infection?
It refers to the characteristic inflammatory diarrhea and gastroenteritis
What is the key virulence factor of Salmonella Enteritidis that allows it to withstand the host's immune response?
The Vi antigen capsule
Why are patients on proton pump inhibitors more susceptible to Salmonella infections?
Proton pump inhibitors decrease the production of stomach acid, which helps Salmonella to more easily pass through the digestive system
What is the characteristic of Salmonella that allows it to cause disease in patients on proton pump inhibitors?
Its acid lability and need for a high dose to cause infection
Study Notes
Salmonella
- Gram-negative, non-lactose fermenter, white on MacConkey's
- Motile, indole negative due to lack of tryptophanase
- H2S positive, colonies stain black on Hektoen agar
- Encapsulated, positive for citrate utilization
- Acid labile, needs high doses to cause infection; patients on proton pump inhibitors are more susceptible
Pathogenesis
- Invades through macrophages to get into the colon
- Facultative intracellular pathogenesis
- Virulence factors: Vi antigen capsule, LPS (Lipid A)
Salmonella Enteritidis
- Reservoir: Chicken
- Caused by eating undercooked chickens, eggs, dairy
- Causes inflammatory diarrhea, gastroenteritis
- Contains type III secretion system that detects eukaryotic cells to increase infectivity
Salmonella Typhi (Typhoid Fever)
- Reservoir: Human
- Harbored in the gall bladder, Typhoid Mary; transmission via fecal-oral route
- Symptoms: rose spots on stomach, hepatosplenomegaly, ileal ulcer
Treatment and Prevention
- Fluoroquinolones (e.g. Cipro) or cephalosporins (e.g. ceftriaxone) for treatment
- Live, attenuated vaccine treatment available
- Antibiotics not warranted for gastroenteritis, do not use antidiarrheal
- Aggressive treatment with chloramphenicol, ampicillin, or TMP/SMX for 10 days for septicemia
Test your knowledge on identifying Salmonella bacteria based on its characteristics such as Gram negative, non-lactose fermenter, motile, H2S positive, and more. Learn about the distinctive traits of Salmonella through this quiz.
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