Difference between revisions of "Salmonellosis"

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* There are many different serotypes of [[Salmonella|''Salmonella'']].
+
There are many different serotypes of [[Salmonella|''Salmonella'']].
** All can produce disease BUT only a few commonly produce illness in UK.  
+
All can produce disease BUT only a few commonly produce illness in UK.  
** ''Salmonella'' poses a serious risk to man.  
+
''Salmonella'' poses a serious risk to man.  
** Some serotypes tend to be more species specific, whereas others can affect a wide range of species. For example:
+
[[Salmonella|'''''Salmonella enteritidis''''']]
*** [[Salmonella|'''''Salmonella enteritidis''''']]
+
[[Salmonella|'''''Salmonella typhimurium''''']]
*** [[Salmonella|'''''Salmonella typhimurium''''']]
+
Widespread in most species.
**** Widespread in most species.
+
[[Salmonella|''''' Salmonella dublin''''']]
*** [[Salmonella|''''' Salmonella dublin''''']]
+
Cattle
**** Cattle
+
[[Salmonella|'''''Salmonella cholerae suis''''']]
*** [[Salmonella|'''''Salmonella cholerae suis''''']]
+
Pigs
**** Pigs
+
Usually speticaemic.
**** Usually speticaemic.
+
Not very common now.
**** Not very common now.
+
[[Salmonella|'''''Salmonella montevideo''''']]
*** [[Salmonella|'''''Salmonella montevideo''''']]
+
Produces outbreaks from contaminated imported meat and bone meal.
**** Produces outbreaks from contaminated imported meat and bone meal.
+
Strains are often named after where they were first isolated.
** Strains are often named after where they were first isolated.
+
Typing is important for epidemiology.
** Typing is important for epidemiology.
+
All strains can occur epizootically, enzootically and sporadically.
** All strains can occur epizootically, enzootically and sporadically.
+
All strains can also produce very similar changes.
** All strains can also produce very similar changes.
+
Salmonellosis is NOT very common in the dog and cat.
* Salmonellosis is NOT very common in the dog and cat.
+
However, the horse is often a carrier.
* However, the horse is often a carrier.
+
Stress may precipitate the disease, meaning Salmonellosis is seen often in veterinary hospitals.
** Stress may precipitate the disease, meaning Salmonellosis is seen often in veterinary hospitals.
 
  
===Pathogenesis===
 
  
* Disease is often seen associated with stress.
+
Disease is often seen associated with stress.
* organisms penetrate enterocytes before crossing the mucosa and entering macrophages.
+
organisms penetrate enterocytes before crossing the mucosa and entering macrophages.
** After entering macrophages, organins may then either remain localised to the gut, or are carried round the body to cause disease.
+
After entering macrophages, organins may then either remain localised to the gut, or are carried round the body to cause disease.
* There are 2 main types of disease- '''septicaemic''' and '''enteric'''.
+
There are 2 main types of disease- '''septicaemic''' and '''enteric'''.
** Each outbreak causes only one type of disease.
+
Each outbreak causes only one type of disease.
** Type of disease is linked to serotype- some serotyopres produce septicaemia, whereas others remain localised in the gut.
+
Type of disease is linked to serotype- some serotyopres produce septicaemia, whereas others remain localised in the gut.
  
  
====Septicaemic Salmonellosis====
 
  
* Septicaemic salmonellosis is very dramatic and produces death quite suddenly.
 
* [[Diarrhoea|diarrhoea]] is often not seen before death.
 
* This form of the disease is unusual in the very young.
 
  
=====Pathogenesis===== 
+
Septicaemic salmonellosis is very dramatic and produces death quite suddenly.
 +
[[Diarrhoea|diarrhoea]] is often not seen before death.
 +
This form of the disease is unusual in the very young.
  
* The organism [[Colon - Anatomy & Physiology|colon]]ises bowel epithelium, where it affects the [[Peyer's Patches - Anatomy & Physiology|Peyers patches]].
+
 
** It then invades macrophages, which enable it to invade across the epithelium to the submucosa. It may then either  
+
The organism [[Colon - Anatomy & Physiology|colon]]ises bowel epithelium, where it affects the [[Peyer's Patches - Anatomy & Physiology|Peyers patches]].
*** Remain localised to submucosa, or  
+
It then invades macrophages, which enable it to invade across the epithelium to the submucosa. It may then either  
*** Spread to the lymph nodes and enter the circulation to become septicaemic.  
+
Remain localised to submucosa, or  
* Animals may die at this stage (30%), but this depends on such factors as the infecting dose and strain.  
+
Spread to the lymph nodes and enter the circulation to become septicaemic.  
* Is similar to septicaemic[[Escherichia coli|'' E. Coli'']].
+
Animals may die at this stage (30%), but this depends on such factors as the infecting dose and strain.  
 +
Is similar to septicaemic[[Escherichia coli|'' E. Coli'']].
  
 
=====Clinical=====
 
=====Clinical=====
Line 56: Line 53:
 
** Bruise-like dark purplish-red blotched may be seen.
 
** Bruise-like dark purplish-red blotched may be seen.
  
=====Pathology=====
 
  
* Intestines
+
Intestines
** May show mild catarrhal enteritis, becoming fibrinous lower down.  
+
May show mild catarrhal enteritis, becoming fibrinous lower down.  
** The bowel is generally flaccid, reddened and filled with fluid.
+
The bowel is generally flaccid, reddened and filled with fluid.
** Ecchymotic and petechial haemorrhages on serosa and mucosa.  
+
Ecchymotic and petechial haemorrhages on serosa and mucosa.  
** Enlarged, haemorrhagic mesenteric lymph nodes.
+
Enlarged, haemorrhagic mesenteric lymph nodes.
* Excessive blood-tinged peritoneal fluid.
+
Excessive blood-tinged peritoneal fluid.
* Lungs are collapsed and frothy.   
+
Lungs are collapsed and frothy.   
* Heart is often dilated with ecchymotic haemorrhages.   
+
Heart is often dilated with ecchymotic haemorrhages.   
* Viscera have a "half-cooked appearance"
+
Viscera have a "half-cooked appearance"
** Pale in colour.   
+
Pale in colour.   
** The [[Liver - Anatomy & Physiology|liver]] and kidneys are also flabby and may have subcapsular haemorrhages.
+
The [[Liver - Anatomy & Physiology|liver]] and kidneys are also flabby and may have subcapsular haemorrhages.
** The [[Liver - Anatomy & Physiology|liver]] may contain small white foci of necrosis known as '''paratyphoid granulomas'''.
+
The [[Liver - Anatomy & Physiology|liver]] may contain small white foci of necrosis known as '''paratyphoid granulomas'''.
  
 
=====Diagnosis=====
 
=====Diagnosis=====
  
* By culture of blood and from mesenteric lymph nodes (which are oedematous and red).
+
By culture of blood and from mesenteric lymph nodes (which are oedematous and red).
  
  
 
====Enteric Salmonellosis====
 
====Enteric Salmonellosis====
  
* Enteric Salmonellosis shows differences in clinical presentation between species.
+
Enteric Salmonellosis shows differences in clinical presentation between species.
 
** '''Horse''' - acute fatal colitis.  
 
** '''Horse''' - acute fatal colitis.  
 
** '''Cows''' - lingering febrile [[Diarrhoea|diarrhoea]] with passage of pseudomembranes.  
 
** '''Cows''' - lingering febrile [[Diarrhoea|diarrhoea]] with passage of pseudomembranes.  

Revision as of 12:47, 30 March 2011

There are many different serotypes of Salmonella. All can produce disease BUT only a few commonly produce illness in UK. Salmonella poses a serious risk to man.

Salmonella enteritidis

Salmonella typhimurium Widespread in most species. Salmonella dublin Cattle Salmonella cholerae suis Pigs Usually speticaemic. Not very common now. Salmonella montevideo Produces outbreaks from contaminated imported meat and bone meal. Strains are often named after where they were first isolated. Typing is important for epidemiology. All strains can occur epizootically, enzootically and sporadically. All strains can also produce very similar changes. Salmonellosis is NOT very common in the dog and cat. However, the horse is often a carrier. Stress may precipitate the disease, meaning Salmonellosis is seen often in veterinary hospitals.


Disease is often seen associated with stress. organisms penetrate enterocytes before crossing the mucosa and entering macrophages. After entering macrophages, organins may then either remain localised to the gut, or are carried round the body to cause disease. There are 2 main types of disease- septicaemic and enteric. Each outbreak causes only one type of disease. Type of disease is linked to serotype- some serotyopres produce septicaemia, whereas others remain localised in the gut.



Septicaemic salmonellosis is very dramatic and produces death quite suddenly. diarrhoea is often not seen before death. This form of the disease is unusual in the very young.


The organism colonises bowel epithelium, where it affects the Peyers patches. It then invades macrophages, which enable it to invade across the epithelium to the submucosa. It may then either Remain localised to submucosa, or Spread to the lymph nodes and enter the circulation to become septicaemic. Animals may die at this stage (30%), but this depends on such factors as the infecting dose and strain. Is similar to septicaemic E. Coli.

Clinical
  • Is usually post-weaning (is unusual in the very young animal).
    • 6 to 9 months in calves.
    • 6 to 10 weeks in piglets.
  • Animals suffer from pyrexia, and occasionally a little bit of diarrhoea.
  • Skin is reddened diffusely
    • Bruise-like dark purplish-red blotched may be seen.


Intestines May show mild catarrhal enteritis, becoming fibrinous lower down. The bowel is generally flaccid, reddened and filled with fluid. Ecchymotic and petechial haemorrhages on serosa and mucosa. Enlarged, haemorrhagic mesenteric lymph nodes. Excessive blood-tinged peritoneal fluid. Lungs are collapsed and frothy. Heart is often dilated with ecchymotic haemorrhages. Viscera have a "half-cooked appearance" Pale in colour. The liver and kidneys are also flabby and may have subcapsular haemorrhages. The liver may contain small white foci of necrosis known as paratyphoid granulomas.

Diagnosis

By culture of blood and from mesenteric lymph nodes (which are oedematous and red).


Enteric Salmonellosis

Enteric Salmonellosis shows differences in clinical presentation between species.

    • Horse - acute fatal colitis.
    • Cows - lingering febrile diarrhoea with passage of pseudomembranes.
    • Calves - acute diarrhoea like colibacillosis.
    • Dogs - acute bouts of diarrhoea.
    • Cats - febrile enterocolitis.
    • Pigs - septicemia or enterocolitis.
Clinical
  • Affected animals produce acute diarrhoea, which causes many deaths.
    • Watery and yellow.
    • May be tinged with a little blood.
  • Animals may die from dehydration.
  • In some outbreaks, particularly in pigs, chronic low-grade diarrhoea only is seen.
  • Calves usually die in acute stage, but may also recover.
Pathology
  • Enteritis is seen throughout the gut, but is worse further along the gut.
    • Inflammation is catarrhal in the duodenum.
    • By the ileocaecal junction enteritis is often fibrinous, sometimes with formation of diptheric membranes on the mucosal surface.
  • The necrotic and fibrinous changes particularly affect the Peyers patches and the caecal and colonic lymphoid nodules.
    • May lead to "button ulcers" in the terminal ileum and colon.
      • These ulcers rupture very rarely.
  • Focal necrosis may also be seen.
    • Particularly in the liver, but also in the spleen.
    • Histologically, foci show a central zone of necrosis, surrounded by macrophages and lymphocytes- paratyphoid granulomas.
      • Although this indicates the animal has had a systemic incfection, paratyphoid granulomas may be present without showing signs of septicaemia.
      • Enteric cases of salmonella infection nearly always show some evidence of systemic spread.
  • Septicaemic form may relocalise in the gut, resulting in enteric disease.
Sequelae
  • Animals can remain carriers for months/years following recovery from the acute diarrhoea phase.
    • Bacteria is shed from the bile duct and mesenteric lymph nodes.
      • A source of infection for other animals and people.
      • Shed particularly in times of stress.
  • Stricture of the rectum.
    • A possible sequel to acute salmonellosis, especially in the piglet.
    • Just a few centimetres in from the anus.
    • Gives rise to:
      1. Difficulty in passing faeces.
      2. Megacolon
      3. thin watery diarrhoea in small 'pencils'.
      4. blown up abdomen
    • Animals eventually die from the stricture if they are not first destroyed.

Ulcerative Enteritis

        • Salmonella typically produces a broad spectrum of disease.
        • Classically may produce 'button' ulcers, especially in the terminal small intestine and upper large intestine (Ileocaecocolic junction).

Hepatitis

  • Salmonella dublin
  • calves
Clinical
Gross
  • severe, often haemorrhagic, inflammation in the ileum
  • paratyphoid nodules - pale foci of necrosis in the liver
Microscopically
  • foci of hepatocytic necrosis
  • mixed mononuclear inflammatory cell infiltrate

NB: small foci of hepatocytic necrosis are often found as incidental lesions at post mortem examination