Typhoid fever is a life threatening illness caused by the bacterium

Salmonella typhus, and was observed by Eberth (1880) in the mesenteric

nodes and spleen of fatal cases of typhoid fever. It is common in developing

countries where it affects about 12.5 million persons annually. The infection

is acquired typically by ingestion. On reaching the gut, the bacilli attach

themselves to the epithelial cells of the intestinal villi and penetrate the

lamina and submucosa. They are then phagocytosed there by polymorphs

and mesenteric lymph nodes, where they multiply and, via the thoracic duct,

enter the blood stream. A transient bacteremia follows,during which the

bacilli are seeded in the liver, gall bladder, spleen, bone marrow, lymph

nodes, and kidneys, where further multiplication takes place. Towards the

end of the incubation period, there occurs a massive bacteremia from these

sites, heralding the onset of the clinical symptoms.

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