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Salmonellosis 

Salmonellosis
Chapter:
Salmonellosis
DOI:
10.1093/med/9780198729228.003.0110
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date: 17 November 2019

Salmonellae are typical members of the Enterobacteriaceae family: motile, non-encapsulated, facultatively anaerobic Gram-negative bacilli. Clinical disease caused by typhoidal serotypes (Salmonella Typhi and Salmonella Paratyphi A and B) differs generally from that caused by other Salmonella serotypes which are collectively called non-typhoidal salmonellae. Transmission to a susceptible host usually occurs via consumption of contaminated foods. The commonest clinical manifestation of infection with non-invasive Salmonella serotypes is diarrhoea, often accompanied by headache, malaise, nausea, vomiting, and crampy abdominal pain. Some Salmonella serotypes have a particular propensity to invade the bloodstream and cause bacteraemia. Bacteraemia occurs more commonly in the neonatal and early infant periods than in older children. The risk for development of focal infections during bacteraemia is higher in children with compromised immunity due to underlying conditions than in previously healthy children. For most patients, oral rehydration is all that is necessary to treat Salmonella gastroenteritis. Antibiotics have no part to play in the management of asymptomatic infection or uncomplicated diarrhoea. However, antimicrobial therapy is recommended for patients who are proven or suspected to be bacteraemic/septicaemic or who are at increased risk of invasive disease, including infants younger than 3 months of age. If antimicrobial therapy is indicated, ampicillin, amoxicillin, or trimethoprim–sulfamethoxazole is recommended for susceptible strains. If resistance is suspected or proven, ceftriaxone, cefotaxime, fluoroquinolones, or azithromycin should be used.

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