BACTERIA

Salmonella Typhi appearance
(Salmonella enterica ssp. enterica serovar Typhi)

Gram-negative rods with rounded ends
motile (peritrichous flagella)
non-spore forming

Infections caused by Salmonella Typhi bacteria

Salmonella Typhi (Salmonella enterica ssp. enterica serovar Typhi) is the causative agent of typhoid fever (typhoid). Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed Salmonella Typhi in their feces (stool). Typhoid fever is common in most parts of the world except in industrialized regions such as the United States, Canada, western Europe, Australia, and Japan.

Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting about a week. Over the course of these stages, the patient becomes exhausted and emaciated. In the second week of the infection, the patient has high fever (around 40 °C) and delirium is frequent. This delirium gives to typhoid the nickname of "nervous fever".

The abdomen is distended and painful in the right lower quadrant. Diarrhea can occur in this stage: six to eight stools in a day, green, comparable to pea soup, with a characteristic smell. However, constipation is also frequent. The spleen and liver are enlarged (hepatosplenomegaly) and tender.

Death occurs in 10% to 30% of untreated cases Wikipedia.

Deaths caused by Salmonella Typhi (2004)

Worldwide incidence:
22,000,000 [1]
Worldwide deaths:
216,000 [2]

[1] GDP Report Disease incidence, prevalence and disability

[2] Deaths and DALYs 2004: Annex tables

Salmonella Typhi treatment
Should be always guided by in vitro susceptibility tests!!

Fluoroquinolones

ciprofloxacin

Cephalosporins III

ceftriaxone
cefotaxime
cefixime (oral)

Alternatives:

ampicillin
chloramphenicol
trimethoprim-sulfamethoxazole
amoxicillin

Resistance to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole and streptomycin is now common. Typhoid resistant to these agents is known as multidrug-resistant typhoid (MDR typhoid)Wikipedia.