Salmonella

• Salmonella enteritidis is a common cause of food borne disease outbreaks
• Infection commonly from foodborne transmission
• Associated with poultry/hen eggs, peanut butter
• Seen in infants often due to cross-contamination in household

• Severity dependent on dose ingested
• Symptoms within 8-72 hours
  • Nausea
  • Vomiting
  • Fever
  • Diarrhea
  • Cramping
• Course: Fever resolves within 48-72 hours; diarrhea resolves within 4-10 days
• < 5% of patients develop bacteremia that is rarely complicated by endocarditis, osteomyelitis, or mycotic aneurysm.
• Mortality < 0.5-1%

• Stool culture

Supportive care

• IVF

Antibiotics

• Have not been shown to reduce duration of symptoms and not recommended in:[2][3]
  • Mild-moderate infection
  • Immunocompetent
  • Patients aged 2-50 years old
• Antibiotics may have a role in patients with:[4]
  • Severe illness
  • IBD
  • Immunocompromised
  • Steroid use
  • < 3 months or > 65 years old
  • On hemodialysis
  • Sickle cell disease
• Recommended regimens:[5]
  • Adults:
    • Levofloxacin (or other fluoroquinolone) 500mg daily x 7-10 days
    • Azithromycin 500mg daily x 7 days
    • Duration should be 14 days in immunocompromised
  • Children:
    • Ceftriaxone 100mg/kg/day divided into two doses x 7-10 days
    • Azithromycin 20mg/kg/day daily x 7 days

• Microbiology (Main)