The molecular mechanisms of severe typhoid fever.
Salmonella typhi continues to cause severe disease in many parts of the world, its most feared complication being perforation of ulcerated Peyer's patches within the small intestine, leading to peritonitis with associated mortality. The pathogenesis of this process is not well understood. In this article, we present a theoretical mechanism as to how bacterial factors and host immunological mediators within infected tissue might contribute to the observed intestinal pathology, and propose that necrosis of the Peyer's patches observed in typhoid is caused by a mechanism similar to the Shwartzman and Koch reactions.
Everest
P
P
Dept of Veterinary Pathology, University of Glasgow Veterinary School, Bearsden Road, G61 1QH, Glasgow, UK. phe3d@udcf.gla.ac.uk
Wain
J
J
Roberts
M
M
Rook
G
G
Dougan
G
G
D004768:Enterotoxins / Q000009:adverse effects; D006801:Humans; D010581:Peyer's Patches / Q000473:pathology; D012485:Salmonella typhi / Q000502:physiology; D012790:Shwartzman Phenomenon; D014435:Typhoid Fever / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*
D004768:Enterotoxins