Typhoid and other septicaemias

By
Dr. Aderemi Kehinde
Department of Medical Microbiology & Parasitology,
College of Medicine,
University of Ibadan
 Outline
A. Septicaemias – -------, ------, etc
B. -------- as an example of septicaemic illness
• Definition
• Aetiological agent
• Pathogenesis & Pathology
• Clinical manifestations
• Laboratory diagnosis
• Treatment
• Complications
• Prevention and control
 Septicaemias
• Septicaemia is defined as ---------
• Bactereamia is --------. It is usually transient –
as seen in some situations such as -------, -----,
etc
 Typhoid fever (TF)
• Definition: TF is defined as ------- Other salmonellae that may
cause a similar clinical syndrome include:
●--------
●--------- (formerly ----------)
●-------(formerly -------)
●---------
• S. typhi is a ------- and a member of the family – --------.
• It shares certain properties with ------ species except that S. typhi
is ------ while Shigella species are -----.
• Secondly, S. typhi produces ------ (H2S) which makes the colonies
------ while Shigella species ---- H2S.
Structure of Salmonella typhi
 Mode of Transmission
• ----- transmission via ---- or ----- handled by an
often ------ individual—a carrier—who
chronically sheds the bacteria through ---- or,
less commonly, -------
• ------- transmission after using a ----- and
neglecting ------ hygiene
• ------ transmission via --------- or ------ (especially
in the developing world)
 Epidemiology
• It is a disease of the ------.
• Associated with poor -------, poor ------, poor ------ and
poor -------- including poor ---------.
• Commoner in ----- areas and --------.
• High prevalent in under-developed/developing countries
of ----- and ------
• S. typhi has been a major human pathogen for thousands
of years, thriving in conditions of -------- , ------, and social
--------.
• Typhoid fever is more common in children and young
adults than in ------ patients.
Global epidemiology of TF
Epidemiology: Risk Areas
 Pathogenesis 1
• ------- route
• Most of the pathogen is destroyed by ------in the -------.
• Survived ones moved to the ------ specifically ----- .
• Multiply in the -------
• S. typhi and ------ enter the host's system primarily
through the ---------. They have specialized ------ that
adhere to the ----- over --------- in the ileum (----), the
main relay point for ------ traveling from the ------- into
the ------ system. The bacteria then induce -------- to
attract -----
 Pathogenesis 2
• Typhoidal salmonella co-opt the --------- for their
own ----- as they are carried through the ------- to
the ------- and the ------ and then through to the -----
-- of the -----, ----, -----, and -----.
• Once there, they ----- and continue to ----- until -----
-- is reached.
• Afterward, the bacteria induce -------, breaking out
into the ------- to invade the rest of the body
 Pathogenesis 3
• The bacteria then infect the ------ via either ------
or --------.
• The result is that the organism ------- in the ----
and re-infects -----.
• Bacteria that do not re-infect the host are
typically ------- and are then available to -------.
Pathogenesis in Picture
 Pathogenesis 4
• --------- are responsible for much of the transmission of
the organism.
• While asymptomatic, they may continue to shed ------
in their ------ for decades. The organisms sequester
themselves either as a ----- on ------ or ----- or, perhaps,
intra-cellularly, within the ------ itself.
• The bacteria excreted by a single carrier may have
multiple -----, making it difficult to trace an outbreak to
its origin.
 Clinical manifestations 1
• The incubation period varies from --- to ----- days and
depends upon ------- and --------.
• Classical onset of the disease is ------- with temperature
variation of ----°C to -----°C, which usually is associated
with ----, ----, and ----.
• Early intestinal manifestations may be ----- and ------, the
latter being more common in ------ and is associated with
-------
• In an untreated patient, ------- is prolonged and may
become ----.
 Frequency of symptoms in typhoid

• F--------
• H-------
• N--------
• V--------
• A------
• D-----
• C-----
• C------
Clinical manifestations 2
Clinical manifestations in Picture
 Laboratory diagnosis 1
--------- tests
• The Gold standard is
isolation of the ----- in --
---- from -------.
• Blood culture using -----
-
 Microbiological investigations contd

• B------ culture – using conventional method.

Blood culture is said to be positive in the first
week of illness
• U-------- culture: Positive 3rd week of illness
• S---------- culture: Positive 2nd week of illness
• B---------- culture
 Other Lab investigations
• S-------- test: W------ test. This is ------ reaction in
which ------ is mixed with ----- and ----- antigens.
• F--------:WBC is ------- in most cases. ------ may be
seen in children and in cases of ------.
PCV – ------ as a result of blood loss and
inflammation
Platelet count- -------
Widal test
 Treatment
• S--------: Rehydrate with ------- to provide ------,
correct ------ and ------ imbalance (-------)
• D-------: ------ is the mainstay of therapy: (i) ----
and ----- generation ----- (C----e); (ii) F------ e(C---
----n)
• Route of administration and duration depend
on the ------ of the disease
Treatment 2
Complications 1
Complications 2
 Prevention & Control
• Based on WASH strategy
• WA: – -------
• S: -------
• H: ---------
 Prevention & Control
• -------- of all cases
• Routine screening and treatment of ------
(among ----- handlers)
Preventive strategies
Thank you for listening