Medical Microbiology

286 4 BacteriaasHumanPathogens

Table4. 8 OverviewoftheMostImportantDifferencesbetweenTyphoidand

EntericSalmonellaeandSalmonelloses

Parameter Typhoid

salmonellae/salmonelloses

Enteric

salmonellae/salmonelloses

Serovars Typhi;ParatyphiA,B,C

(seeTable4. 7 )

OftenEnteritidisand

Typhimurium;morerarely:

numerousotherserovars

Infectionspectrum Humans Animalsandhumans

Sourceofinfection Humans:infectedpersons,

chroniccarriers

Mainlylivestock;possibly

humansaswell

Modeofinfection Oral Oral

Transmission Indirect:water,contaminated

food

Direct:smearinfection

Indirect:contaminatedfood

Infectivedose Small: 102 –1 03 bacteria Large:> 106 bacteria;inmost

casesproliferationinfood

Incubationtime 1 – 3 weeks 1 – 2 days

Clinicalpicture Generalizedinfection.

Sepsis

Acutediarrheawithvomiting.

Fever.Self-limitinginfectionin

mostcases

Diagnosis Identificationofpathogenin

blood,stool,urine.

Antibodydetectionusing

Gruber-Widalquantitative

agglutinationreaction

Identificationofpathogenin

stool

Therapy Antibiotics:aminopenicillins,

4-quinolones

Symptomatictherapy:

loperamide,replacementof

waterandelectrolytelossesas

required(WHOformula)

Occurrence Sporadic;usuallyimported

fromcountrieswithendemic

typhoidfever

Endemic,epidemicsinsmall

groups(family,cafeteria,etc.)

orasmassinfection

Prevention Exposureprophylaxis:

Drinkingwaterandfood

hygiene;eliminationof

pathogeninchroniccarriers.

Immunizationprophylaxis:

Activeimmunizationpossible

(travelers)(seep. 28 7f.)

Exposureprophylaxis:

Foodhygiene

4

Kayser, Medical Microbiology © 2005 Thieme