XI.

PATHOPHYSIOLOGY
Medical Diagnosis
Typhoid fever, Acute Gastroenteritis (AGE)
Definition
Typhoid fever - is a life-threatening illness caused by the bacterium Salmonella typhi.
Acute Gastroenteritis (AGE)- Gastroenteritis (also known as gastro, gastric flu, tummy bug in some countries, and stomach
flu, although unrelated to influenza) is inflammation of the gastrointestinal tract, involving both the stomach and the small
intestine (see also gastritis and enteritis) and resulting in acute diarrhea.

Schematic Diagram
Predisposing
Geographical area tropical islands in the
Pacific (Philippines) and Asia
Young adult(19-45) 40yrs old

Ingestion of foods or fluids contaminated

with Salmonella typhi bacteria

Bacteria enter the stomach and survive a pH

as low as 1.5

Bacteria invades the Payers patches of the

intestinal wall in the small intestines where it
attach (incubation period is first 7-14 days
after ingestion)

Precipitating
Washing of hands inadequately
Sharing of food from the same plate
Drinking unpurified water
Eating foods from the outside source (carinderia)

Diagnostic:
Hematology:
Neutrophils-74
(50-70)

Bacteria will then injects toxins known as

the effector proteins into the intestinal cells
and interrupts with the cellular proteins &
lipids & manipulate their function resulting
in phagocytization of the epithelial cell
membrane until it is engulf down into the
inferior part of the host cells where
macrophages is present.
Macrophages & intestinal epithelial
cells then attract T cells &
neutrophils with interleukin 8 (IL-8
causing inflammation of the
intestinal wall)
The bacteria is within the
macrophages and survives

Bacteria spread via the lymphatics

while inside the macrophages

The bacteria induced macrophage

apoptosis, breaking out into the
bloodstream and cause systemic
infection

Signs/ symptoms:
Febrile: T-38.5C
Warmth to touch
Headache of 3/10, body
weakness

Typhoid
Fever

Perforation and
destruction of
mucosal lining of the
intestinal wall can
lead to persistent
inflammation
Ulceration and
bleeding in the
mucosal lining and
leads to necrosis

Signs/
symptoms:
Abdominal pain

Diagnostic:
Fecalysis: reddish
brown color
(brown)
RBC:2-4/hpf(0-

Tissue damage and

inflammation causes
loss of absorption
due to damaged villi
causing an increase
in water, electrolytes,
mucus, blood, and
serum to be pulled
into the intestine
from immature crypt
cells
Abdominal spasm is
induced to limit
mucosal injury adding
in stimulation of
increased peristalsis

Signs/ symptoms:
RUQ Abdominal pain of
5/10 pain scale,
guarding behavior,
facial grimace,
tachypnea-RR of
38cpm,

Acute
Gastroenteritis

Complications:
Bile is infected and typically
shed in the stool and are
then available to infect
other hosts

Legend:
- Pathophsiology

- Signs and symptoms

- Diagnostic exams

- Complications

Complications:
Peritonitis
Pancreatitis
Hepatic and splenic
abscesses Disseminated
intravascular coagulation
Myocarditis
Shock
Death

Signs/ symptoms:
Diarrhea, defecates 5-7
times at night, soft
watery stool 2-3 cups
per episodes,
hyperactive bowel
sounds of 16 clocks per
minute, dry skin,
anorexia, decreased
body weight