Mohamad, Ayah S.

Pathophysiology of Maradi’s Condition

Contaminated food/water

Salmonella typhi

Attach to mucosa of small

intestine

Penetration of mucous layer

of gut

Mucosal injury Infiltration via M cells (ileum)

PMN recruitment Formation of membrane

ruffler
1st Type III secretion system

Cytokine Bacteria-mediated endocytosis

release

Inflammation & Replication of bacteria

enlargement of ileum

RLQ pain Vacuole reaches submucosa

2nd Type III secretion system

Obstruction

Constipation  Passage Phagocytosis by macrophages Cytokine release

Bulging of ↑ intraabdominal Dissemination into Fever

Cul-de-sac pressure reticuloendothelial system via
lymphatics

Vomiting
P-Treatment Plan

Objective Pharmacologic Non-pharmacologic Diagnostics/Referrals

To determine if CBC
patient has - Leukocytosis (>5-
infection and 10 x 10 L) means
identify any there is infection
underlying - Haemoglobin of
problems <12 g/dl is
diagnostic of
anemia
ABG – to determine any
acid-base disturbance
due to vomiting
Blood chemistry – to
assess the patient’s
electrolytes
- May also reveal
hypoalbuminemi
a due to
malnutrition
To confirm and Blood culture
identify the Antimicrobial
causative agent susceptibility testing
of the infection
and its
susceptibility
To manage the Paracetamol 15 mg/kg Sponge bath
fever every 4-6 hours
administered by infusion
over 15 minutes
To give Ceftriaxone 2 g/d (IV) for
empirical 10-14 days
treatment for Azithromycin 1 g/d (PO)
the infection for 5 days
To correct the NPO
malnutrition Plain NSS
and dehydration
of the patient