Salmonella typhi

Salmonella typhi is a Gram-negative, motile rod-shaped bacterium and belongs to the pathogenic enterobacteria.

Salmonella typhi causes a systemic infection known as typhus. The disease progresses in different stages: 

  • Stadium incrementi (first week): Headaches, nausea, fever, constipation

  • Stadium fastigii (second to third week): Fever, abdominal pain, diarrhea, impaired consciousness, cough, roseole (skin rash)

  • Stadium decrementi (fourth to fifth week): gradual regression of symptoms

  • Complications: Intestinal bleeding, intestinal perforation, meningitis

Salmonella typhi is most common in developing countries; in industrial nations the pathogen occurs primarily as an imported infection due to travel.

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Low

  • Pulmonology: Not relevant

  • Ear, nose, and throat: Not relevant

  • Urology: Not relevant

Relevance for endoscope surveillance

  • High concern organism

Transmission route

Salmonella typhi is transmitted from human to human via the fecal-oral route as well as via contaminated water and food (fertilized fruit/vegetables, mussels, oysters).

Resistance to antibiotics

Reduced antimicrobial susceptibility is described, including against fluoroquinolones and sulfonamides. Multi-resistance is increasingly occurring in Asia and Africa.

Sources and further readings

  1. Beecham HJ 3rd et al. Salmonella typhimurium. Transmission by fiberoptic upper gastrointestinal endoscopy, JAMA. 1979 Mar;241(10):1013–1015.

  2. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.

  3. Typhus abdominalis, RKI-Ratgeber, Robert Koch-Institut, Accessed on 08.05.2021.

  4. Typhoid Fever and Paratyphoid Fever, Centers for Disease Control and Prevention, Accessed on 08.05.2021.