Salmonellosis (salmonella gastroenteritis)

• Pathogens: Salmonella enterica serotype Enteritidis, Salmonella enterica serotype Typhimurium, Salmonella enterica serotype Heidelberg

  • Gram-negative bacteria, obligate pathogens

  • Produce hydrogen sulfide

  • Do not ferment lactose

  • 2nd most common group of pathogens responsible for bacterial foodborne gastroenteritis

  • High infectious dose required (104–106 pathogens), depending on the strength of an individual's immune system

• Transmission: foodborne (poultry, raw eggs, and milk), reptiles (e.g., pet turtles or snakes)

• Incubation period: 0–3 days

• Prevention: no vaccine available

• Duration: 3–7 days

• Fever (usually resolves within 2 days), chills, headaches, myalgia

• Severe vomiting, abdominal pain, and inflammatory (watery-bloody) diarrhea

• Supportive therapy for gastroenteritis: e.g., bland diet, oral rehydration therapy

• Antibiotic therapy

  • Not routinely indicated

  • Indications: severe cases of nontyphoidal Salmonella (consider also for high-risk patients )

  • Preferred regimens (usually given for 7–10 days )

    • Fluoroquinolones: e.g., ciprofloxacin

    • OR cephalosporins. e.g., ceftriaxone

  • Alternatives

    • Trimethoprim/sulfamethoxazole

    • OR azithromycin

Antibiotic treatment for salmonellosis prolongs fecal excretion of the pathogen. Therefore, it is only indicated for severe nontyphoidal Salmonella infections (e.g., in patients with systemic manifestations or ≥ 9 episodes of diarrhea per day, and those who require hospitalization).

Complications are more frequent in immunocompromised patients, e.g., those with HIV.

• Bacteremia

• Chronic Salmonella carriage

• Systemic disease: e.g., osteomyelitis, meningitis, myocarditis, aortitis

• Reactive arthritis