Typhoid fever (enteric fever) - Salmonella typhiGram neg. bacillus Virulence: Endotoxins (cell wall lipids). Organisms invade m.m. & other organs →enteric fever (begins in GI tract, enters blood, spreads throughout body).Transmission: Fecal-oral routeP/E: Oral cavity - contaminated food, H2ODisease: Inc. pd. 1 - 3 wks. Organism localizes in small intestine→invades m.m., lymphatic tissues (Peyers patches. In first week - fever, headache, malaise, diarrhea. In second week endotoxins cause ulceration intestinal wall (sometimes perforates) →bloodstream →septicemia →spreads to other organs: (liver, kidneys, spleen, bone marrow, skin, gall bladder). Symptoms more acute - severe abdominal pain, severe diarrhea with blood, pus, weakness, abdominal distention. Other symptoms depend on organs infected. Rose spots in skin - due to multiplication organisms.Carrierstate: Common following illness. Organisms remain in gall bladder - must be surgically removed to eliminate.
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