Typhoid fever is caused by the bacterium Salmonella typhi. It is transmitted through contaminated food or water. S. typhi bacteria infect the intestines and sometimes spread to the bloodstream, causing systemic infection. Symptoms include sustained fever, headache, vomiting, diarrhea, and abdominal pain. Laboratory diagnosis involves culturing bacteria from blood or urine samples or detecting antibodies in serum using tests like the Widal test. Effective treatment is with antibiotics such as ciprofloxacin or ceftriaxone. Rehydration is also important, and in severe cases surgery may be needed if the bowel is perforated.

1. Seminar on
Typhoid Fever
GOKULRAJ. K
M.Sc., Microbiology
Periyar university

2. History
Morphology
Antigenic Structure
Pathogenicity
Symptoms
Laboratory diagnose
Treatment

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.

6. Salmonella typhi

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

13. Fever Headache
Vomiting

14. Diarrhea Chills Abdominal Pain

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.