Typhoid fever pathophysiology: Difference between revisions

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Revision as of 22:12, 30 August 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S [2]

Overview

Pathogenesis

The pathogenesis of typhoid fever consists of following sequence of events.

Innoculation

Orofecal transmission.
Infective dose 1000 to 1 million organisms.

Gastrointestinal Infection

Stomach

Bacterium enters stomach.
Survives pH as low as 1.5

Small intestine

Adherence to mucosal cells via special proteins.
Invade mucosal M cells overlying peyer's patches
Internalisation in M cells of ileum.
Translocation to underlying lymphoid tissue and draining lymph nodes.

Systemic spread

Dissemination of S.typhi to reticuloendothelial system.
Spreads via lymph and blood
Replication within reticuloendothelial system such as spleen, liver, bone marrow.
Evades immune system by hiding intracellularly within macrophages.

Chronic carrier state

Resides and multiplies in gall bladder
Excretion in urine and stool infecting other individuals.

References

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Template:WS

@@ Line 4: / Line 4: @@
 {{Typhoid fever}}
-{{CMG}}
+{{CMG}}; {{AE}}{{AA}}
 == Overview ==
-== Pathophysiology ==
-<br>
-{{Family tree/start}}
-{{Familytree|boxstyle=width: 300px; text-align: left; background: #FFF0F5| | | | A01 | | | |A01=  '''Innoculation'''
-*Orofecal transmission
-*Infective dose 1000 to 1 million
-}}
-{{Family tree | | | | |!| | | | | }}
-{{Familytree|boxstyle=width: 300px; text-align: left;background: #FFF0F5| | | | B01 |-| B02| |B01='''Gastrointestinal Infection'''
+==Pathogenesis==
+The pathogenesis of typhoid fever consists of following sequence of events.
+===Innoculation===
+*Orofecal transmission.
+*Infective dose 1000 to 1 million organisms.
-'''''Stomach'''''
-*Enters stomach
+===Gastrointestinal Infection===
-*High tolerance for acid
+'''Stomach'''
-*Survives PH as low as 1.5
+*Bacterium enters stomach.
-'''''Small intestine'''''
+*Survives pH as low as 1.5
-*Adherence to mucosal cells
+'''Small intestine'''
-*Invade mucosal M cells overlying payers patches
+*Adherence to mucosal cells via special proteins.
-*Internalisation in M cells
+*Invade mucosal M cells overlying peyer's patches
-*Translocation to underlying lymphoid tissue and draining lymph nodes
+*Internalisation in M cells of ileum.
-|B02= '''Systemic spread'''
+*Translocation to underlying lymphoid tissue and draining lymph nodes.
-*Dissemination of ''[[S.typhi]]'' to reticuloendothelial system
+===Systemic spread===
+*Dissemination of ''[[S.typhi]]'' to reticuloendothelial system.
 *Spreads via lymph and blood
-*Replication within reticuloendothelial system
+*Replication within reticuloendothelial system such as spleen, liver, bone marrow.
-*Evades immune system
+*Evades immune system by hiding intracellularly within macrophages.
-}}
-}}
+===Chronic carrier state===
-{{Family tree | | | | |!| | | | | }}
-{{Familytree|boxstyle=width: 300px; text-align: left;background: #FFF0F5 | | | |B01| | | |B01= '''Chronic carrier state'''
 *Resides and multiplies in gall bladder
-*Excretion in urine and stool}}
+*Excretion in urine and stool infecting other individuals.
-{{Family tree/end}}
-== Genetics ==
-Typhoid fever may be associtated with genes of the Class II and Class III Major Histocompatibility Complex.<ref>Dunstan, Sarah J., et al. "Genes of the class II and class III major histocompatibility complex are associated with typhoid fever in Vietnam." Journal of Infectious Diseases 183.2 (2001): 261-268.</ref>
-Two types of HLA associations can be found with typhoid fever:<ref name="pmid12456854">{{cite journal| author=Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ| title=Typhoid fever. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 22 | pages= 1770-82 | pmid=12456854 | doi=10.1056/NEJMra020201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12456854  }} </ref>
-*HLA-DRB1*0301/6/8, HLA-DQB1*0201-3, and TNFA*2(–308) associated with increased susceptibility to typhoid fever.
-*HLA-DRB1*04, HLA-DQB1*0401/2, and TNFA*1(–308)associated with increased disease resistance.
 == References ==
@@ Line 55: / Line 43: @@
 {{WS}}
+[[Category:Infectious disease]]
+[[Category:Gastroenterology]]