PATHOPHYSIOLOGY OF TYPHOID FEVER WITH COMPLICATIONS

RISK FACTORS
Predisposing Precipitating
Age: 2 years old and onwards (pt. Is 33 years old) Salmonella typhi
Lifestyle: Poor sanitation practice (hand washing is Contaminated water and food
ninadequate after urinationd and defecation) Presence of flies
Diet: Eating raw and half-cooked meats, seashells,
and fleshy foods.
Environmental: Congested place/living

STARTS IN

Ingestion of suitable S. typhi

THEN

Passing through GI tract and gastric barrier

GOING TO

Small intestine targeting Payer’s patches

CAUSING

S. typhi phagocytised
BY

Intraluminar dendritic cells causing M cells (Microfold cells) Epithelial cells maturing to
inflammation professional phagocytes

Diarrhea

RESULTING TO
Presentation to macrophages and T-
cells in lamina propria

a. Serve as a vehicle b. Resistance to digestion c. For reproduction

EXITS VIA

Mesenteric lymph node

SPREAD VIA

Reticuloendothelial System
 Dec. Lymphocytes = 0.08 IN
Inc. WBC = 19.5

Blood (bacteremia and Fever 38 degC

sepsis) Chills, Insomnia,
Body Weakness

RESULTING

Typhidot = IgM Positive

TYPHOID FEVER Abdominal pain

FURTHER LEADS TO

Latency and Multiplication causing systemic disease

LIVER GASTROINTESTINAL
(Enterocolitis) KIDNEY
 Diagnostic test:  Diagnostic test:
X-ray reveals  Diagnostic test:
a. Increase a. Increase
minimal creatinine by
hapatomegaly prothrombin
time by 18 307.4 umol/L
suggesting non- (may indicate
parenchymal seconds
b. Decrease Na by kidney failure)
inflammation b. Urinalysis
132.7 mmol/L
reveals dark
 Manifestations:
yellow in color,
a. GI bleeding as
bacteria = +3,
evidenced by
WBC = 4-6
black-tarry
stool
b. Diarrhea
c. Vomiting
d. Dec. BP by
60/40
e. Inc. Sweating
f. Borborygmus

LIUNGS
 Diagnostic test:
X-ray reveals
pneumonitis on the
right lower lobe
 Manifestations:
a. Rhonchi
b. Increase
mucus
secretions

GALLBLADDER LIVER
 Diagnostic test:  Diagnostic test:
X-ray reveals Increase alanine
acalcuous amino transferase
cholecystitis by 74.0 (may
indicate liver injury)