Salmonella Typhimurium Colitis

Green, P. H. R.; Middleton, W. R. J.

doi:10.1111/imj.1976.6.4.345

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…[2][3][4][5][6][7][8][9][10][11] In this country the illness may be confused with bacillary dysentery, or idiopathic illcerative colitis. Patients with idiopathic ulcerative colitis may develop superinfection by S typhimurium.…”

Section: Discussionmentioning

confidence: 99%

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Boyd¹

1985

Gut

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SUMMARY The pathology of the alimentary tracts of nine patients dying of Salmonella typhimurium infection is reviewed. Two patients had previous gastric operations, supporting previous reports that such patients are more susceptible to food poisoning. Four had no parietal (oxyntic) cells in the gastric mucosa, suggesting hypo-or anacidity. Only one had acute gastritis. None had acute enteritis, but in half of the patients, subtle histological changes suggested an 'enteropathy'. Acute diffuse colitis with abundant crypt abscesses, without stromal abscesses in the lamina propria, was the most constant finding and reparative features started very early, and occurred in later deaths. Under ideal circumstances this crypt abscess is readily distinguished from that of idiopathic ulcerative colitis, but can be confused with the crypt abscess of acute bacillary (sonne) dysentery. While the florid colonic changes may have settled in the late deaths, active inflammation is commonly present in the appendix mucosa on histology. The pathology of the alimentary tract in S typhimurium infection differs from that of S typhi and S paratyphi infections. There is little evidence of gastroenteritis, although subtle changes occur in the stomach and small intestine. The features are those of acute diffuse colitis with histological appendicitis, distinguishable from idiopathic ulcerative colitis.Statistics suggest that the incidence of food 1,oisoning in the United Kingdom is increasing. Food poisoning is commonly referred to as 'gastroenteritis', implying inflammation of the stomach and small intestine. During an outbreak of S typhimurium (phage type 32) infection in the west of Scotland in 1968, it was surprising to find virtually no gastritis, or enteritis, and that the predominant histological lesion was an acute diffuse colitis.2Further experience has been gained from S typhimurium infection of other phage types and from other salmonella subtypes.3 Other publications-11 have confirmed the colitis component of S typhimurium infection, but the findings in the stomach and small intestine remain un-reported. Indeed, the colonic findings have not been adequately described. In this paper the pathology of the alimentary tract in nine patients dying from S typhimurium infection, involving at least four phage types is described. The first necropsy was done before phage typing had been routinely accepted. Methods NECROPSIESThe nine necropsies were carried out as soon after death as possible. Two loops of jejunum and two of sigmoid colon were sent for microbiological examination and virology. Blood samples from the right auricle were also taken for culture and Widal tests.The necropsy was standard with the gastrointestinal tract being dissected out and opened with the minimum of handling. Hosing with water and sponging was avoided to allow inspection of the luminal contents and the undisturbed mucosal surfaces.After formalin fixation standard sets of blocks for histological examination were taken from the gastric fundus, jejunum, jejuno-ile...

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Section: Discussionmentioning

confidence: 99%

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Boyd¹

1985

Gut

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“…Salmonella infection, including nontyphoidal salmonellosis, usually causes disease of the small intestine, but cases of colonic involvement have been reported 27,28 ; these cases may mimic inflammatory bowel disease. 29,30 Many salmonella species have been implicated in cases of both distal and proximal colonic disease, without any link between the pattern of involvement and the particular species.…”

Section: Pathological Discussionmentioning

confidence: 99%

Case 16-2001

LaMont¹,

Graeme‐Cook²

2001

N Engl J Med

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A 17-year-old girl (gravida 1, para 1) was admitted to the hospital because of abdominal pain, fever, and diarrhea.The patient had been in good health before admission. Three weeks earlier, she had undergone a cesarean section because of multiple bouts of fetal bradycardia; the infant was delivered at 40 weeks of gestation. The pregnancy was otherwise uneventful. She received a single dose of gentamicin and two doses of clindamycin intravenously in the peripartum period. Her postpartum course was uneventful, and she was discharged on the third postoperative day.Three days before admission, the patient began to have pain in the right lower quadrant of her abdomen. The pain became more severe the next day and was accompanied by very frequent, watery stools that were brown and later black, nausea, and a temperature that peaked at 38.3°C. She passed no fresh blood. One day before admission, 2 liters of fluid with electrolytes was administered intravenously. On the day of admission, the pain became more severe and was unrelieved by acetaminophen-oxycodone, although the diarrhea had ceased.The patient did not have a history of previous abdominal pain or exposure to patients with gastroenteritis, and there was no family history of inflammatory bowel disease. She resided in eastern Massachusetts.The temperature was 38.7°C, the pulse was 104, and the respirations were 16. The blood pressure was 130/70 mm Hg.On examination, the patient was in considerable pain. Her abdomen was soft but exquisitely tender in the right lower quadrant, without rebound tenderness; bowel sounds were diminished. A stool specimen contained occult blood.The urine was normal; the sediment contained 0 to 2 red cells and 3 to 5 white cells per high-power field. The results of hematologic studies performed at various times during the hospital stay are shown in Table 1. Blood chemical values were normal. A computed tomographic (CT) scan of the abdomen and pelvis, obtained after the rectal administration of contrast material (Fig. 1), revealed concentric thickening of the wall of the cecum and proximal ascending colon, with fat stranding and prominent lymph nodes in the adjacent mesentery. A transabdominal and transvaginal ultrasonographic study of the pelvis showed no abnormalities.Morphine was given intravenously. A blood specimen and a rectal swab were obtained for culture. Ampicillin, gentamicin, and fluid and electrolytes were administered intravenously; heparin was injected subcutaneously, and metronidazole was given orally. Total parenteral nutrition was instituted. The temperature rose to 39.1°C on the first hospital day. The uterus was not tender; its size corresponded to a 12-week gestation; there was no discharge.On the second hospital day, the temperature rose to 38.8°C. Blood chemical tests were performed on this day and subsequently during the hospital course ( Table 2). An abdominal radiograph showed no abnormalities. The administration of analgesia, controlled by the patient, was begun. The pain improved briefly, but the patient refused...

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Assessment and Control of Microbiological Health Risks Presented by Foods

Mossel

1980

Food and Health: Science and Technology

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Salmonella Typhimurium Colitis

Cited by 4 publications

References 8 publications

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

Case 16-2001

Assessment and Control of Microbiological Health Risks Presented by Foods

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