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Seminar on
Typhoid Fever
GOKULRAJ. K
M.Sc., Microbiology
Periyar university
History
Morphology
Antigenic Structure
Pathogenicity
Symptoms
Laboratory diagnose
Treatment
History
Salmonella was named after Daniel Elmer
Salmon (1850-1914), an American veterinary
pathologist, who described Salmonella
enterica (formerly S. choleraesuis).
However, it was his colleague and subordinate
Theobald Smith (better known for his work on
anaphylaxis) who first discovered the
bacterium in 1885, from pigs, in an
investigation for the cause of hog cholera.
Daniel Elmer Salmon (1850-1914)
Morphology
 Salmonellae are gram negative rods. They are
motile with peritrichate flagella.
 Salmonellae are aerobic and facultatively
anaerobic bacteria growing readily on simple
media over a range of pH 6-8 & temperature
15-41°C with optimum temperature of 37°C.
Salmonella typhi
Antigenic Structure
 Salmonellae possess the antigens and based on
which they are classified as
(i) flagella antigen H,
(ii) Somatic antigen O and
H antigen
 This antigen present on flagella is heat labile
protein.
 It is destroyed by boiling or by treatment with
alcohols but not by formaldehyde.
O antigen
 O antigen is a Phospholipid-protein-
polysaccharide complex which forms an
integral part of the cell wall.
 It is identical with endotoxin. This is unaffected
by boiling, alcohol or weak acids
Pathogenecity
 Salmonellae cause the following clinical
syndrome in human beings
1. Enteric fever
2. Gastroenteritis or food poisoning
3. Septicemia with or without local suppurative
lesions
1. Enteric Fever
 This includes typhoid fever caused by S.typhi and
paratyphoid fever caused by S.Paratyphi A,B,C. the
infection is acquired by ingestion of contaminated
food, on reaching the gut the bacilli attach to microvilli
of the ileal mucosa and penetrate submucosa.
 They are phagocytosed by polymorphs and
macrophages.
 Their ability to resist intercellular killing and to multiply
within the cells is a measure of their virulence. They
enter the mesenteric lymph nodes,
 where they multiply and via thoracic duct, enter the
blood stream causing bacteremia.
2.Gastroenteritis or food poisoning
 Salmonellae gastroenteritis or food poisoning is
zoonotic disease, the source of infection being
animal products and may be caused by any
Salmonellae except S typhi.
 Human infection results from ingestion of
contaminated food and most common source of
food poisoning are poultry, meat, milk products.
 Salmonellae can enter through the shell if eggs
are left on contaminated chicken feed or feces
and grow inside.
3.Septicemia
 S choleraesuis in particular, may cause
septicemic disease with focal suppurative
lesions such as osteomyelitis, deep
abscesses, endocarditis, pneumonia and
meningitis
Fever Headache
Vomiting
Diarrhea Chills Abdominal Pain
Laboratory Diagnosis
 Bacteriological diagnosis of enteric fever
consists of isolation of the bacilli and
demonstration of antibodies in serum.
 Blood culture
 Urine culture
Widal Test
SLIDE TEST
 Place one drop of positive control on one
reaction circles of the slide.
 Pipette one drop of Isotonic saline on the next
reaction cirlcle. (-ve Control).
 Pipette one drop of the patient serum tobe
tested onto the remaining four reaction circles.
 Add one drop of Widal TEST antigen
suspension ‘H’ to the first two reaction circles.
(PC & NC).
Widal test kit Widal slide
test
 Add one drop each of ‘O’, ‘H’, ‘AH’ and ‘BH’
antigens to the remaining four reaction circles.
 Mix contents of each circle uniformly over the
entire circle with separate mixing sticks.
 Rock the slide, gently back and forth and
observe for agglutination macroscopically
within one minute.
Treatment
 The only effective treatment for typhoid is
antibiotics. The most commonly used are
ciprofloxacin (for non-pregnant adults) and
ceftriaxone.
 Other than antibiotics, it is important to
rehydrate by drinking adequate water.
 In more severe cases, where the bowel has
become perforated, surgery may be required.
Typhoid fever

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Typhoid fever

  • 1. Seminar on Typhoid Fever GOKULRAJ. K M.Sc., Microbiology Periyar university
  • 3. History Salmonella was named after Daniel Elmer Salmon (1850-1914), an American veterinary pathologist, who described Salmonella enterica (formerly S. choleraesuis). However, it was his colleague and subordinate Theobald Smith (better known for his work on anaphylaxis) who first discovered the bacterium in 1885, from pigs, in an investigation for the cause of hog cholera.
  • 4. Daniel Elmer Salmon (1850-1914)
  • 5. Morphology  Salmonellae are gram negative rods. They are motile with peritrichate flagella.  Salmonellae are aerobic and facultatively anaerobic bacteria growing readily on simple media over a range of pH 6-8 & temperature 15-41°C with optimum temperature of 37°C.
  • 7. Antigenic Structure  Salmonellae possess the antigens and based on which they are classified as (i) flagella antigen H, (ii) Somatic antigen O and H antigen  This antigen present on flagella is heat labile protein.  It is destroyed by boiling or by treatment with alcohols but not by formaldehyde.
  • 8. O antigen  O antigen is a Phospholipid-protein- polysaccharide complex which forms an integral part of the cell wall.  It is identical with endotoxin. This is unaffected by boiling, alcohol or weak acids
  • 9. Pathogenecity  Salmonellae cause the following clinical syndrome in human beings 1. Enteric fever 2. Gastroenteritis or food poisoning 3. Septicemia with or without local suppurative lesions
  • 10. 1. Enteric Fever  This includes typhoid fever caused by S.typhi and paratyphoid fever caused by S.Paratyphi A,B,C. the infection is acquired by ingestion of contaminated food, on reaching the gut the bacilli attach to microvilli of the ileal mucosa and penetrate submucosa.  They are phagocytosed by polymorphs and macrophages.  Their ability to resist intercellular killing and to multiply within the cells is a measure of their virulence. They enter the mesenteric lymph nodes,  where they multiply and via thoracic duct, enter the blood stream causing bacteremia.
  • 11. 2.Gastroenteritis or food poisoning  Salmonellae gastroenteritis or food poisoning is zoonotic disease, the source of infection being animal products and may be caused by any Salmonellae except S typhi.  Human infection results from ingestion of contaminated food and most common source of food poisoning are poultry, meat, milk products.  Salmonellae can enter through the shell if eggs are left on contaminated chicken feed or feces and grow inside.
  • 12. 3.Septicemia  S choleraesuis in particular, may cause septicemic disease with focal suppurative lesions such as osteomyelitis, deep abscesses, endocarditis, pneumonia and meningitis
  • 15. Laboratory Diagnosis  Bacteriological diagnosis of enteric fever consists of isolation of the bacilli and demonstration of antibodies in serum.  Blood culture  Urine culture
  • 16. Widal Test SLIDE TEST  Place one drop of positive control on one reaction circles of the slide.  Pipette one drop of Isotonic saline on the next reaction cirlcle. (-ve Control).  Pipette one drop of the patient serum tobe tested onto the remaining four reaction circles.  Add one drop of Widal TEST antigen suspension ‘H’ to the first two reaction circles. (PC & NC).
  • 17. Widal test kit Widal slide test
  • 18.  Add one drop each of ‘O’, ‘H’, ‘AH’ and ‘BH’ antigens to the remaining four reaction circles.  Mix contents of each circle uniformly over the entire circle with separate mixing sticks.  Rock the slide, gently back and forth and observe for agglutination macroscopically within one minute.
  • 19. Treatment  The only effective treatment for typhoid is antibiotics. The most commonly used are ciprofloxacin (for non-pregnant adults) and ceftriaxone.  Other than antibiotics, it is important to rehydrate by drinking adequate water.  In more severe cases, where the bowel has become perforated, surgery may be required.