CASE HISTORY
In October 2013,Kelsey was a 28-year-old computer programmer who worked for a prominent technology firm in Silicon Valley.In the middle of the night,Kelsey awoke with abdominal cramps and diarrhea.Her temperature spiked as high as 40°C (104°F).She had a bad headache and could not retain sufficient fluids.After three days,her fever subsided,but the diarrhea continued (about 20 times a day)and began showing blood.Kelsey was admitted to the hospital,where she was given intravenous fluids to control her dehydration.The physician asked her about her dietary history preceding the onset of symptoms.Kelsey recalled that the night before onset,she had eaten rotisserie chicken cooked at the supermarket.An antibody test confirmed the diagnosis of Salmonella enterica serovar heidelberg.Because of the severity of her symptoms,Kelsey was treated with antibiotics,although sometimes antibiotics may prolong the persistence of Salmonella.When amoxicillin failed to control the infection because of bacterial resistance,ciprofloxacin was used.Ultimately,Kelsey's illness was one of more than 400 cases in 23 states traced to contaminated chicken from one California farm.Kelsey recovered,but three months later, S.heidelberg could still be detected in her feces.
Kelsey's illness is caused by a facultative intracellular bacterium,meaning when causing infection it may enter human cells.Explain the process by which large particles such as a bacterial cell can enter membrane covered cells like human intestinal epithelia.
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