Professional Documents
Culture Documents
Shellfish
From contaminated water.
"Recreational" Drugs
Marijuana and other drugs.
Animal Dyes
Dyes (eg, carmine) used in drugs, foods, and cosmetics.
Household Pets
Turtles, dogs, cats, etc.
Enterobactericeae
Table. Clinical Diseases Induced by Salmonellae.
Salmonella Typhi
Fever
Food and
Mouth Small intestine
Beverage
Bloodstream lymphatic
(Transient bacteremia) vessels
Organs Bloodstream
(Liver, spleen) (Secondary bacteremia)
Recovery (relapse)
or death
In the third
and fourth
week
Diagnostic Laboratory Tests
Specimens
Blood for culture must be taken repeatedly. In
enteric fevers and septicemias, blood cultures are
often positive in the first week of the disease.
Bone marrow cultures may be useful.
Urine cultures may be positive after the second
week.
Stool specimens also must be taken repeatedly. In
enteric fevers, the stools yield positive results from
the second or third week on; in enterocolitis, during
the first week.
A positive culture of duodenal drainage establishes
the presence of salmonellae in the biliary tract in
carriers.
Bacteriologic Methods for
Isolation of Salmonellae
1. Differential Medium Cultures
2. Selective Medium Cultures
3. Enrichment Cultures
4. Final Identification
Serologic Methods
1. Agglutination Test
2. Tube Dilution Agglutination Test (Widal
Test)
The Widal test to detect these antibodies
against the O and H antigens carried out
in week two to four fever.
Therapy
DIFFERENTIAL DIAGNOSIS
Paratyphoids A, B & C The laboratory is
usually required as the final authority. The
paratyphoids tend to run a milder course with
profuse rose spots. Geographic distribution
sometimes simplifies the matter; the paratyphoids
are rare in East Africa, but paratyphoid B is not
uncommon in Britain.
Salmonella infection and gastroenteritis
Salmonellae, the dysentery group, and
staphylococci may occasionally cause an invasive
illness resembling typhoid fever with bacteremia.
Usually, however, the gastrointestinal symptoms
are more acute than the general manifestations,
and the pyrexia much lower and of shorter
duration.
DIFFERENTIAL DIAGNOSIS
Other diseases in differential diagnosis
a.Malaria This may be mistaken for typhoid in
countries where both are endemic. A history of
previous attacks, the more rapid onset in malaria,
the shivering and sweating, the high early
pyrexia, the relative infrequency of abdominal
symptoms and signs, and a positive blood slide
all point to a diagnosis of malaria.