Enteric fever is caused by ?
**Core Concept**
Enteric fever, also known as typhoid fever, is a systemic infection caused by the ingestion of food or water contaminated with the bacteria Salmonella Typhi (S. Typhi) or Salmonella Paratyphi. The bacteria invade the intestinal mucosa, leading to a febrile illness characterized by abdominal pain, diarrhea, and systemic symptoms.
**Why the Correct Answer is Right**
S. Typhi invades the intestinal mucosa by adhering to the microvilli of enterocytes via the FimH adhesin. The bacteria then enter the bloodstream and disseminate to various organs, including the liver, spleen, and bone marrow. The immune response to S. Typhi infection involves the production of IgM and IgG antibodies, as well as the activation of T cells.
**Why Each Wrong Option is Incorrect**
* **Option A:** Vibrio cholerae is the causative agent of cholera, a different type of enteric infection characterized by profuse diarrhea and vomiting.
* **Option B:** Shigella dysenteriae is a cause of dysentery, a type of enteric infection characterized by bloody diarrhea and abdominal cramps.
* **Option C:** Escherichia coli (E. coli) can cause various types of enteric infections, including urinary tract infections and traveler's diarrhea, but is not the primary cause of enteric fever.
**Clinical Pearl / High-Yield Fact**
It's essential to consider enteric fever in the differential diagnosis of fever of unknown origin, particularly in patients who have traveled to or live in areas where S. Typhi is endemic.
**Correct Answer:** C. Salmonella Paratyphi.