Salmonella
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More Specific Terms
- Salmonella arizonae
- Salmonella enteritidis
- Salmonella hirschfeldii
- Salmonella paratyphi
- Salmonella poona
- Salmonella schottmuelleri
- Salmonella typhi
- Salmonella typhimurium
Epidemiology
- associated with animal reservoirs, especially poultry & eggs
- transmission to children following handling of pet reptiles
- asymptomatic shedding of the bacteria in the stool occurs for weeks even after appropriate antibiotic therapy
Clinical-manifestations
- Salmonella gastroenteritis indistinguishable from gastroenteritis caused by other organisms
- typically, non-bloody diarrhea
- outbreak in 2012 associated with a sushi variety called "spicy tuna" [2]
Laboratory
- lactose -; H2S +; gas +; indole -; methyl red +; Voges-Proskauer -; urease -; motility +; lysine +; ornithine decarboxylase +; malonate -; KCN -
- stool culture may take up to 72 hours to become positive [1]
Complications
- 5% of patients may develop complications of bacteremia
- endocarditis or other endovascular infection
- osteomyelitis [1]
Management
- supportive
- hygiene, contact precautions
- infected food handlers should remain at home until asymptomatic
- prolong the carrier state
- do NOT affect the course of the disease
- use only if blood cultures as positive
- antibiotics:
- patients < 2 years of age & > 50 years of age
- severe infection requiring hospitalization
- known or suspected atheromas or bone prosthesis because of possible seeding during bacteremia
- immunosuppressed patients
- duration of therapy
- 7-10 days in immunocompetent patients
- minimum of 2 weeks in immunosuppressed patients
- fluoroquinolones are 1st line[1]
- Bactrim
- amoxicillin
- antibiotic susceptibility testing indicated
More General Terms
References
- Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
- Lester E Tuna linked to salmonella outbreak in 20 states Associated Press [1]
- Salmonella Infections: NIH Institute and Center Resources [2]
