Bacteria Causing Gastrointestinal Infections
K. Balamurugan, U. Prithika in Pocket Guide to Bacterial Infections, 2019
Salmonella typhi cause illness called typhoid fever or enteric fever. They are more of a systemic illness rather than a primary GI infection. Humans are the only known reservoir of S. typhi. The organism penetrates the intestinal epithelial cells and reaches the lymphatics with very little inflammation; hence, GI symptoms are less in the initial space. They then proliferate in the reticuloendothelial organs, leading to hepatosplenomegaly and are released systemically in large numbers in the next phase with resultant involvement of various systemic organs. During this phase, the GI system might be exposed with heavy bacteremia especially in the payer’s patches of terminal ileum. The organisms are also seen abundantly in gall bladder. The lymphoid follicles in the payer’s patches might then ulcerate and lead to complications like bleeding and ulcerations, which are seen commonly by the third week of the illness (Figure 1.1). Patients usually recover by 4 weeks, but a few continue to harbor the organism in the gallbladder or other organs and become carriers. They continue shedding the bacteria in feces and cause recurrent outbreaks of infection in the community.
Salmonella
Dongyou Liu in Laboratory Models for Foodborne Infections, 2017
With an incubation period of about 2 weeks, typhoid fever caused by Salmonella Typhi, Paratyphi A, Paratyphi B and Paratyphi C is an invasive disease that tends to occur in immunocompetent individuals. Its main symptoms include fever, headache, a slowed heart rate (bradycardia), and sepsis, but diarrhea is largely absent [9]. During the infection, Salmonella goes through the lymphatic system of the intestine into the blood (typhoid form) and migrates to various organs (liver, spleen, kidneys) to form secondary foci (septic form). Histologically, inflammatory infiltrates in the intestine are predominantly mononuclear cells, with few neutrophils. The bacterium is found in histiocytic granulomas (or typhoid nodules) located in the bone marrow, the liver, and the spleen. In a small proportion (approximately 4%) of patients, the bacterium remains in the gallbladder for a period of 1 year after disease resolution. These chronic carriers (or “typhoid Marys”) can transmit the disease for the rest of their lives [1,10,11].
Pediatric colorectal surgery in low- and middle-income settings: Adaptation to the resources available
Alejandra Vilanova-Sánchez, Marc A. Levitt in Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
A previously well 5-year-old male presents with an acute abdomen and severe septic shock after 5 days of diarrhea and vomiting. At laparotomy, total colonic necrosis is found, extending up to the peritoneal reflection. Traditional hot-water enema administration is denied by caregivers but is suspected by the clinicians. After a damage control laparotomy at which a total colectomy is done with ligation of the terminal ileum and the abdomen is closed with a Bogota bag, an end-ileostomy is created at a relook laparotomy 48 hours later. The rectum is necrotic to the dentate line at the time of relook laparotomy. Histology of the resected necrotic bowel demonstrates ganglionated bowel, and an infectious agent is not identified. (Serological tests for Salmonella typhi and stool samples for Campylobacter, Yersinia, Shigella, hemorrhagic Escherichia coli, and amoebiasis are negative.)
The role of the microbiome in drug resistance in gastrointestinal cancers
Published in Expert Review of Anticancer Therapy, 2021
Ingrid Garajová, Rita Balsano, Heling Wang, Francesco Leonardi, Elisa Giovannetti, Dongmei Deng, Godefridus J. Peters
Hepatobiliary and pancreatic cancers are aggressive diseases with a poor prognosis [41–44]. Though pancreas, gallbladder, and liver are not part of the alimentary canal, these organs are essential to digestion and pancreatic cancer, biliary tract, and liver cancer are exposed to the gut microbiome via blood flow through the portal vein [45]. It has been demonstrated that the composition of intestinal microbiota is associated with the progression of nonalcoholic steatohepatitis [46] and liver cirrhosis [47] which are correlated with liver tumor development. Furthermore, a possible role of H. pylori and other Helicobacter species has been found in hepatocellular cancer. In particular, Helicobacter hepaticus may colonize the bile tract and the large intestine and promote liver tumor development in a mouse model [48]. Similarly, biliary tract cancers have been associated with Helicobacter species, in particular H. pylori, Helicobacter bilis and H. hepatics [49,50]. In addition, Salmonella typhi infection is associated with an increased risk of gallbladder cancer [51].
Frosted Branch Angiitis in a Patient with Typhoid Fever
Published in Ocular Immunology and Inflammation, 2018
Mamta Agarwal, Jambulingam Malathi, Jyotirmay Biswas
A 16-year-old Asian Indian girl presented in our clinic with complaints of painless, progressive decrease in vision in her left eye for the last 10 days. She had a history of fever with headache for 2 weeks, and was diagnosed to have enteric fever. Laboratory investigations showed raised erythrocyte sedimentation rate of 58 mm in 1 h, positive WIDAL test for Salmonella typhi O and H antigens, negative serology for Dengue virus, and negative blood smear for malarial parasites. Blood culture was positive for Salmonella typhi. She was on treatment with oral cefixime and ofloxacin twice a day. On examination, visual acuity was 6/12 and 6/18 in the right and left eye, respectively. Slit-lamp examination showed a quiet anterior chamber and few vitreous cells in the right eye and fresh keratic precipitates (Figure 1C), anterior chamber cells and flare 2+ with vitreous cells 2+ in left eye.
Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA)
Published in Expert Review of Anti-infective Therapy, 2022
Aislinn Cook, Mike Sharland, Yasmine Yau, PediBSI Group*, Julia Bielicki
For susceptibility to 3GC (e.g. cefotaxime, ceftriaxone): Number of ESBL-producing isolates was used where reported (Klebsiella spp., E. coli, and Enterobacter spp.);0% susceptibility due to intrinsic resistance in Acinetobacter spp., Pseudomonas spp., Enterococcus spp.;Assumed 100% susceptibility for Salmonella Typhi, non-typhoidal Salmonella spp., GAS, S. pneumoniae and H. influenzae;For Citrobacter spp., Serratia spp., Proteus spp., Raoultella spp. assumed same proportion susceptible as reported for Klebsiella spp.; andAll reported methicillin-susceptible S. aureus (MSSA) were assumed susceptible.
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