Salmonella typhi and Salmonella paratyphi most commonly cause typhoid, or enteric fever, in which an acute febrile illness is preceded by ingestion of the organism and a short course of diarrhea, which resolves before the onset of fever. Non-typhoidal Salmonella, however, is the most common cause of food-borne diarrhea, transmitted via contaminated meats, poultry, eggs, and dairy products. Food handlers can be reservoirs. Rarely, outbreaks are water-borne or from Pet reptiles, which are frequently carriers. Patients with non-typhoidal illness often present with nausea, vomiting, and diarrhea 6 to 48 hours after ingestion of contaminated food. Abdominal pain and fever are common, but bloody stools occur less frequently. Stool examination reveals leukocytes, and routine cultures will be positive in 58% of cases.Most cases of gastroenteritis resolve without treatment in 3 to 7 days.Symptoms of colitis may persist for several weeks. Treatment can prolong the fecal excretion of organisms and should be avoided in mild cases. Antibiotics should be given to patients with severe symptoms, at extremes of age, with immunosuppression, with cardiovascular disease, or with a prosthesis, as the organism has a propensity to infect vascular aneurysms and prosthetic joints. Carriage of non-typhoidal salmonella can persist for 4 to 5 weeks after resolution of diarrhea. Fluoroquinolones, ampicillin, and trimethoprim-sulfamethoxazole are acceptable agents to treat Salmonella infection. Length of treatment is usually 1 week, but if the patient is bacteremic or focally infected, longer courses are necessary.*67/348/5*
-
Posted by admin @ 2:32 pm
