Salmonellosis
Alerts and Notices
Synopsis
The symptoms of nontyphoidal gastroenteritis include low-grade fever, chills, nausea, vomiting, diarrhea, and abdominal cramps. The incubation period is typically 6-72 hours, and illness lasts up to a week. One report of children with this infection noted that 29% had bloody diarrhea, many had fever and vomiting, and some presented with signs of dehydration.
An asymptomatic carrier state may exist for months after recovery from infection. In most cases, antibiotic therapy is not necessary. Rarely (<8% of cases), nontyphoidal gastroenteritis is complicated by bacteremia. For some patients, antibiotic therapy for gastroenteritis might be prescribed if they are felt to be at increased risk for extra-intestinal infection (eg, neonates, the elderly, or immunosuppressed patients). In one small case series, children with bacteremia typically had dysentery and fever on admission. Some had convulsions. Also rare is a reactive arthritis following Salmonella infection. This can be associated with iritis and urethritis.
The CDC has classified drug-resistant nontyphoidal Salmonella and drug-resistant Salmonella serotype typhi as serious concerns. They note that 67% of S. typhi are drug-resistant.
See Typhoid Fever for discussion of Salmonella enterica serotype typhi and Salmonella enterica serotype paratyphi A, B and C, which produce the most severe forms of the illness (typhoid and paratyphoid fevers) and are found in most parts of the world except in industrialized regions.
Codes
ICD10CM:A02.0 – Salmonella enteritis
SNOMEDCT:
302231008 – Salmonellosis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Acute bacterial gastroenteritis (Campylobacter, Shigella, Escherichia coli O157:H7)
- Viral gastroenteritis is usually not associated with dysentery or high fever.
- Other toxin-mediated gastroenteritides
- Gastroenteritis due to protozoan infection (Giardia, Cryptosporidium, Cystoisospora, Cyclospora) is usually not associated with dysentery or high fever.
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Last Reviewed:02/28/2017
Last Updated:02/17/2021
Last Updated:02/17/2021
Patient Information for Salmonellosis
Overview
Salmonella is the name for a family of bacteria that cause diarrheal illness in humans. Salmonella is most commonly thought of as the bacteria that lives on raw poultry, and while this is true, it is also found on raw beef, milk, eggs, and even fruits and vegetables. It can be spread directly from the contaminated food or from fecal contact with an infected person.Salmonella bacteria are the type of bacteria that cause "food poisoning" (ie, fever, vomiting, and diarrheal illness caused by contaminated food). This type of "food poisoning" is more properly called salmonellosis. Salmonella typhi is a type of Salmonella that causes typhoid fever; this also includes fever, vomiting, and often diarrheal illness, but it is much more severe than salmonellosis. Salmonella can also be spread from animals to humans; reptiles (including pet turtles) and chicks and ducklings (even those that look well and are not sick) can spread Salmonella and cause salmonellosis in humans.
How do I get Salmonella?
- By eating or drinking foods contaminated with Salmonella, usually raw or undercooked poultry or beef, raw milk, raw eggs, or contaminated fruits and vegetables.
- By handling certain animals, such as reptiles (including pet turtles), chicks, or ducklings.
Who’s At Risk
Anyone who comes into contact with Salmonella-infected foods may develop symptoms of vomiting and diarrhea; the very young, very old, and those who have a compromised immune system are at much higher risk of developing more serious complications from salmonellosis, such as bacteria in the blood stream (sepsis) and death.Signs & Symptoms
Symptoms of salmonellosis include the following:- Fever
- Diarrhea
- Abdominal cramps
- Vomiting
Self-Care Guidelines
Stay hydrated, preferably with a liquid that contains some sugar and electrolytes, such as a sports drink. Drink at least 2 liters of liquid a day. Eat a bland (not spicy) low-fat diet. Avoid milk and dairy products until the diarrhea improves. Practice good hand hygiene, as the bacteria can easily be spread from one person to another through fecal contamination.When to Seek Medical Care
If the diarrhea becomes bloody or lasts longer than a few days, or if you develop a high fever, see your doctor. If you experience signs of dehydration, such as dizziness or fainting, or if you have mental confusion, see a doctor immediately.Treatments
Some Salmonella infections do not necessarily need to be treated, so your doctor may not prescribe anything.Typhoid and paratyphoid fever (caused by S. typhi and Salmonella paratyphi, respectively) are usually treated with antibiotics. Your doctor may test a sample of your stool for cells and bacteria, and he/she may choose to prescribe an antibiotic based on this test.
There is no vaccine available for the types of Salmonella that cause salmonellosis. There is a vaccine available for S. typhi, however, the bacterium that causes typhoid fever.