Tashkent Medical Academy Department of Infectious and Pediatric

Tashkent Medical Academy Department of Infectious and Pediatric Infectious Diseases SALMONELLOSIS Lecturer: Ph. D. , associate professor Karimova M. T.

Plan: 1. Introduction - 5 min. 2. Historical data - 5 min. 3. Etiology and Epidemiology - 10 min. 4. Pathogenesis and pathological anatomy 10 min. 5. Clinic - 30 min. 6. Diagnostics - 8 min. 7. Treatment - 10 min. 8. Prevention - 7 min. 9. Conclusion - 5 min.

Salmonellosis is a polietiologic infectious disease caused by bacteria of different serotypes of Salmonella, is characterized by a variety of clinical manifestations from asymptomatic carriage to severe forms.

Aetiology 1) Causative agent: belongs to the Salmonella class, Enterobactericae family 2) Gram-negative 3) Length 0. 2 -0. 4 m, width - 0, 5 m 4) The dispute does not form capsules. 5) Has flagella from 8 to 12, a movable. 6) forms a colony in weak alkaline p. H 7. 4 -7. 5 7) Antigenic properties: heat stable O-antigen on the membrane, thermolabile flagellar H-antigen and capsular surface K - antigen.

Pathogenic properties of the causative agent 1) The pathogenic types of the causative agent for humans: typhoid, paratyphoid monopatogen n 2) The pathogenic types of the causative agent for animals and birds: monopatogen. n 3) The pathogenic types of the causative agent for animals and humans: bipatogen, Salmonella anatum, Salmonella london. n

Epidemiology 1) Antropozoonoznaya infection occurs in humans and animals. 2) Source of infection: a sick man and bacillicarriers 4) It occurs sporadically. 3) Modes of transmission: nutritional - food; contact - home; water. 5) After recovering formed type-specific monoimmunity. 6) The disease occurs in all age groups: especially in children and the elderly is more severe.

Pathogenesis 1. 2. 3. 4. 5. 6. The introduction of Salmonella Primary regional infection Bacteremia Toksinemia The defeat of the organs and systems Restoration of damaged function.

n Endotoxin -action on the mucous membrane of the digestive tract, the neurovascular unit gut – generalized paralysis vazomotorov occursreduction of tonus - increased permeability. This leads to inflammation of the intestinal mucosa and develop catarrhal-hemorrhagic gastroenteritis.

n This leads to hypersecretion, increased motility and spasm of the bowel. n Hypersecretion is mainly associated with the violation of a cyclic adenylyl cyclase - c. AMP system.

n Under the influence of endotoxin activates the enzyme adenylate cyclase, located on the membrane of red blood cells, resulting in disturbed synthesis of c. AMP, which activates the intracellular enzymatic processes. This leads to the release of the intestinal lumen of a large amount of electrolytes and water, which causes the diarrheal syndrome.

Imbibing endotoxin in the blood, affects the CNS and ANS. n Reducing A / R, slowing blood flow in the capillaries leads to circulatory collapse. n Endotoxin affects the capillaries and prekapillyary, the blood clotting system and disturbs the microcirculation in all organs and tissues. Developing hypoxia - acidosis - Dystrophy - necrosis endotoxic shock. n

Clinical classification 1) Gastroenteriticheskaya form: A) acute gastritis (5. 7%) B) Acute gastroenteritis (75 -80%) B) acute gastroenterocolitis (5 -10%) 2) Generalized form: A) tifopodobnaya B) septic 3) of bacteria: a) Acute b) dough biscuits a) Chronic d) A transient 4) Nozoparaziticheskaya form

Gastrointestinal form The incubation period of 3 - 5 hours to 2 -3 days. n Gastritic option: occurs in 5 -10% of cases. n - the beginning is an acute n - chills, headache n - increase in body temperature n - epigastric pain n - Anorexia n - nausea, vomiting n

Gastroenteritis version the beginning is an acute n Symptoms of intoxication (chill, headache, weakness, increase in temprature) n Cramping around the abdomen. n Nausea, vomiting, bringing relief. n Diarrhea - profuse, offensive, with mucus n Flatulence. n Hepatomegaly n

Moderate dehydration: skin loses its turgor and elasticity. If the skin is gathered into folds, normally crushes at once, with dehydration is very slowly. This phenomenon is clearly visible in the picture

Gastroenterokolitic version Symptoms are the same: n Even more frequent stools with mucus, blood, tenesmus, false desires. n

Diagnostics The general analysis of blood, urine, feces. n Biochemical analysis. n Bacteriology. n Serological O-AGA, TPHA n 1: 200 n RAC 1: 80 n

Differential diagnostics n n n n Dysentery, PC PTI, botulism Cholera Yersiniosis Typhoid, paratyphoid Septic conditions Myocardial infarction

Dysentery Stool mixed with mucus and blood-streaked Tenesmus

Cholera Bowel movements a sick person Vomit Collection of vomit

Cholera algid

Typhoid fever Temperature curve

Typhoid fever

Typhoid fever Thickening and coated tongue brown patina

TREATMENT n Regime n Diet n Etiotropic treatment n Pathogenetic treatment n Symptomatic treatment