References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
| Agent | BACTERIUM. Salmonella A facultative gram-negative bacillus |
| Reservoir | Mammal Bird Reptile |
| Vector | None |
| Vehicle | Food Milk Eggs Poultry Shellfish Meat Vegetables Fruit Fecal-oral Fly |
| Incubation Period | 12 to 36 hours (As early or late as 6 hours to 5 days) |
| Diagnostic Tests | Culture (stool, blood, infected tissue) Serology |
| Typical Adult Therapy | Stool precautions. Therapy not indicated for uncomplicated diarrhea; if necessary, treat per antibiogram |
| Typical Pediatric Therapy | As for adult |
| Clinical Hints | Fever, chills & watery diarrhea 12 to 24 hours after ingestion of eggs, meat, poultry; fecal leucocytes present; fever resolves in 2 days; but diarrhea persists for up to 7 days (occasionally weeks). |
| Synonyms | Salmonellosen, Salmonellosi |
WHO Case Definition for Surveillance
An illness with the following symptoms: diarrhea, abdominal cramps, fever, vomiting and malaise.
Laboratory criteria for confirmation: Isolation of Salmonella spp. from the stool or blood of a patient.
Case classification
- Suspected: An individual showing one or more of the clinical features.
- Confirmed: A suspected case with laboratory confirmation.
Acute Infection
Salmonella gastroenteritis is usually indistinguishable from that caused by other bacterial and viral pathogens.
- Nausea, vomiting, and diarrhea begin 6 to 48 hours following ingestion of contaminated food or water.
- Incubation periods as long as 8 days have been reported.
- Abdominal cramps and fever as high as 39°C are common.
- The diarrhea is usually characterized as loose, non-bloody stools of moderate volume.
- Voluminous diarrhea, bloody stools, and tenesmus may also occur. The infection is usually self-limited.
- Fever resolves within 3 days, and diarrhea resolves within 3 to 7 days.
- Stool cultures may remain positive for 4 to 5 weeks after infection, and carriage may persist for as long as one year in fewer than 1% of cases.
- Antibiotic treatment is reserved for unusual and complicated infections: septicemia, neonates, immunosuppressed patients, etc.
Complications
The spectrum of extraintestinal salmonellosis is similar to that of other gram-negative bacterial infections: osteomyelitis, meningitis, endocarditis, etc.
- Endovascular infections are particularly common, and may result in aneurysms of the aorta and other large vessels.
- Salmonella osteomyelitis is common in children with underlying hemoglobinopathies. Pyomyositis has also been reported in such cases.
- Septicemia is often described in patients with schistosomiasis, lymphoma, lupus erythematosus, bartonellosis, malaria and hepatic cirrhosis.
- Rotavirus infection increases the risk of bacteremia in children with nontyphoid Salmonella gastroenteritis
- Elderly patients are at risk for complicated or fatal infection.
- Reactive arthritis has been reported in as many as 16.8% of cases
- The risk for reactive arthritis following Salmonella infection was 1.4/100,000 cases (United States, 2002 to 2004)
- There is evidence that salmonellosis may increase the risk for later development of inflammatory bowel disease.