Granulomatous Inflammatory Response in a Case of Typhoid Fever

Abstract

Objective: To present a case of culture-proven typhoid fever in which granulomas were demonstrated histologically in the ileum and mesenteric lymph nodes. Clinical Presentation and Intervention: A 47-year-old Pakistani man underwent emergency hemicolectomy for severe bleeding per rectum associated with diarrhea. Two large ulcers in the ileum, near the ileocolic junction, as well as mesenteric lymph nodes showed both necrotizing and non-necrotizing granulomas in addition to mixed inflammatory infiltrate on histology. Conclusion: Typhoid fever may be considered as one of the causes of the differential diagnoses of granulomatous inflammation of the small intestine.

Humanized nonobese diabetic-scid IL2rγnullmice are susceptible to lethalSalmonellaTyphi infection

“…The hu-SRC-SCID mouse represents a tractable small-animal model that reproduces a number of important pathological and inflammatory features of human typhoid fever. The pathological abnormalities provide experimental correlates of the hepatocellular toxicity, splenic typhoid nodules, Kupffer cell swelling, and granulomatous inflammation with multinucleated giant cells observed in human typhoid (46)(47)(48)(49)(50)(51)(52). Hepatic centrilobular microvesicular changes and splenic lymphocyte apoptosis (53,54), general systemic responses to lipopolysaccharide in both normal and humanized mice, were also evident.…”

Host Specificity of Bacterial Pathogens

“…This suggests that S. Typhi requires human hematopoietic cells to proliferate and cause progressive infection in vivo. The pathology observed in hu-SRC-SCID mice infected with S. Typhi resembles human typhoid in a number of respects, including hepatic Kupffer cell swelling and splenic granulomatous inflammation with epithelioid macrophages and multinucleated giant cells (Mallory 1898;Ayhan et al 1973;Bharadwaj et al 2009). Elevated serum levels of the cytokines IL-6, IFN-g, and TNF-a are also observed, as in patients with typhoid fever (Butler et al 1993;Keuter et al 1994).…”

Bone Marrow Granuloma in Typhoid Fever: A Morphological Approach and Literature Review

“…However, the morphological characterization of typhoid fever in bone marrow has been rarely described in the literature [ 3 – 5 ]. Furthermore, differentiating typhoid BMG from that of tuberculosis, in the absence of culture correlation, may lead to initiation of long duration, toxic antitubercular therapy (ATT) [ 6 – 9 ]. In this paper, we describe a case of BMG in a culture proven case of typhoid fever with special emphasis on the morphological differentials with a brief review on the relevant literature.…”