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Published by drparachuru
Salmonella typhi,
Salmonella paratyphi
Salmonella enteritidis
Salmonella choleraesuis

Salmonella typhi,
Salmonella paratyphi
Salmonella enteritidis
Salmonella choleraesuis


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Published by: drparachuru on Oct 15, 2013
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Kingdom: Bacteria Phylum: Proteobacteria Class: Gamma Proteobacteria Order: Enterobacteriales Family: Enterobacteriaceae Genus: Salmonella Species: e.g. S.



Flagella stained Salmonella Typhi peritrichous flagella


Courtesy By CDC

• • • •

Gram negative rods, facultative anaerobes, facultative intracellular parasites Oxidase negative, Motile peritrichous, Lactose negative - color less colonies on Mackonkey agar H2S positive:
• Hektoen Agar color full colonies • Wilson and Blair bismuth sulfate media – H2S producing, grow as black colonies

• Acid labile • Taxonomic classification problematic because of different Antigenic serotypes • Pathogenic Salmonella – species - Salmonella enterica
• • • • Salmonella typhi, Salmonella paratyphi Salmonella enteritidis Salmonella choleraesuis

Virulent factors
• Type I Pili • H Antigen ( Flagellar Antigen)
• Phase Variation, Immunogenic

• K Antigen –
• Vi Capsular Antigen( S.Typhi) - Inhibits Compliment Mediated Killing. Poorly Immunogenic

• O Antigen:
• Somatic Antigen (LPS) Less Immunogenic Than H Antigen • Endotoxin

Widal Test – O And H Antigen (Positive Results After 13 Days) • Type III Secretary System (12 Proteins):
• Endocytosis, ↓ Phagosome Lysosome Fusion, Promotes Replication, ↑Prostaglandins, ↑cAMP


• Majorly By Contaminated Food: • At Outdoor Social Gatherings, Poultry Products, Including Eggs • Salmonella Enteritidis & Choleraesuis: • Large Infectious Dose (105 Or Higher) • 50,000 Cases Were Reported In United States In 2010. • ↑Summer And Fall • Oral Fecal Route • Turtle • Salmonella Typhi And Paratyphi: • Person-to-person Spread - Food And Water • Low Dose Of Infection • ↑ Leukemia, Lymphoma, Sickle Cell Disease, ICP, And Reduced Gastric Acidity • Chronic Pts- Gallbladder And Biliary Tract



Pathogenesis Gastroenteritis
Salmonella Enteritidis & Choleraesuis

Attach to enterocytes by Type I pili

Initiates inflammatory response → ↑Prostaglandins and ↑cAMP → Dysentery

Injects Type III secretary proteins

Endocytosis → release Type III proteins in endosome and replicates

Released into sub mucosa → may be by apoptosis

Dr.Aravind osteomyelitis, pneumonia, and meningitis Salmonella choleraesuis can disseminate

Pathogenesis of Salmonella


Courtesy by HHMI

Pathogenesis Enteric fever (Typhoid fever)
Salmonella Typhi and Paratyphi Biliary Tract And Gall Bladder (Chronic) → Intestine

Attach To Enterocytes And M Cells With Pili

Disseminates To Mesenteric Lymph Nodes, Liver And Spleen

Release Type III Secretary System Proteins In Host Cells

Vi Antigen Inhibits Macrophage & Compliment Killing → Replication

Endocytosis → Release Type III Proteins In Endosome And Replicates

Released Into Sub Mucosa → And Taken By Macrophages

Clinical Conditions Gastroenteritis
• 24 To 48 Hours Incubation • Symptoms: • Nausea, Vomiting, Abdominal Cramps, Diarrhea And Dysentery. • Predominant Symptom For 3 To 4 Days And Resolves In 7 Days • Dissemination: • Salmonella Choleraesuis In Sickel Cell Pts And ICP • Osteomyelitis, Endocarditis, Arthritis

Enteric fever or Typhoid fever
•Ten to 14 days incubation •Symptoms:
• Step ladder increasing fever, headache, myalgia, malaise, constipation and anorexia. • Rose spots on Abdomen and trunk • Repeated chronic cases blood diarrhea • Hepatosplenomegaly

• Complications:
• • • • • Infection of Peyer’s patches, Perforation of intestine, Thrombophlebitis (inflammation of vein wall), Cholecystitis (inflammation of GB), pneumonia, Osteomyelitis , Arthritis and CNS infections


• Specimens – Blood Or Feceas • Lactose Negative, H2S positive, Motile • Blood Cultures Are Positive In First For Typhi • Culture Medium – Mackonkey’s Agar, Hecktoen Agar, W&B Media. • Serology Widal Test.
• 1 Week – 85% Blood Cultures Are Positive, Pts Get Rose Spots On Abdomen And Trunk • 2 Week – Widal Test Will Be Positive • 3 Week – Stool Cultures Are Positive

Treatment & Prevention
• Enteric Fever:
• Fluoroquinolones, Chloramphenicol, Trimethoprim,Or Cephalosporin's
Typhoid Mary

• Gastroenteritis:
• Antibiotics Not Recommended For Enteritis

• Prevention:
• Proper Preparation Of Poultry And Eggs (Completely Cooked) • Carriers Of Salmonella Typhi And Salmonella Paratyphi Should Be Identified And Treated • Vaccine For Typhi Against Vi Antigen.


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