Abstract

SALAZAR MORALES, Miguel Fernando; ESTRADA HERNANDEZ, María del Rocío  and  PARRAGUIRRE MARTINEZ, Sara. Enteric fever in fastigium phase; epicritic notes on a necropsy case. Rev. Fac. Med. (Méx.) [online]. 2012, vol.55, n.6, pp.26-34. ISSN 2448-4865.

Typhoid fever is a multisystemic disease of infectious etiology with the gramnegative rod Salmonella typhi as its causative agent. We present the case of a 19 year old woman who started with fever, abdominal cramps and diarrhea progressing to hepatic insufficiency, acute tubular necrosis, rhabdomyolysis and thrombocytopenia dying three days after hospital admission. Autopsy findings were as follows: Peyer's patches ulcers, necrosis and inflammation of mesenteric lymph nodes, dotted ulcers in colon, lung hepatisation, hepatic, splenic and renal congestion, as well as purpuric lesions in mesencephalon and pons. Microscopic examination revealed macrophage clusters surrounding spots of necrosis (typhoid nodules) in the next locations: arachnoid mater, brain parenchyma, lung, liver, spleen, kidney and bone marrow. These findings supported a diagnosis of typhoid fever at fastigum stage. Typhoid fever goes through 5 consecutive stages whose morphological expression is product of several interactions between Salmonella typhi and the mononuclear phagocyte system of its host.

Keywords : Typhoid fever; Salmonella typhi; typhoid nodule; Mallory's cells; mononuclear phagocytic system.

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