The Salmonella genus has more than 2500 different serotypes [1], which cause a variety of symptoms. The set of syndromes resulting from Salmonella infection (salmonellosis) are gastroenteritis, septicemia, focal disease, and enteric fever, in addition to the carrier state, which is asymptomatic.

Gastroenteritis, of which there are more than one million cases per year in the USA, is brought on by salmonellae belonging to the non-typhoidal group, most commonly by serotypes Enteritidis, Typhimurium, Newport, Heidelberg, and Javiana of Salmonella enterica subspecies enterica. Most non-typhoidal Salmonellae have broad host ranges, and animals are their main reservoir. Salmonella is transmitted to humans mainly by contaminated foods: meat, milk, eggs, vegetables, or any food not carefully handled. However, direct contact with animals, and with products consumed or used by them may also lead to infections [2]. Children under the age of 5, infants who are not breastfed [3], the elderly, those with gastrectomy or reduced stomach acid [4], the immunocompromised, and people with hemolytic conditions have an increased risk for salmonella infection.

The symptoms of salmonella enteritis are abdominal pain, diarrhea, fever, nausea, and vomiting. The episode may last from a few days to a week and usually does not require antimicrobial treatment, although in some cases, the diarrhea may cause severe dehydration.

Salmonellae invade the enterocytes in the gut, and in some rare cases continue to spread through the lymph nodes to other organs, among them the liver, spleen, and bones. Invasive infections can cause bacteremia, osteomyelitis, meningitis and septic arthritis. Bacteremia occurs infrequently, mainly in the very young and in the elderly population [5] [6], after infection with a few particular serotypes, for example, Salmonella enterica subspecies enterica serotype Typhimurium (commonly, although inaccurately referred to in an abbreviated form as S.Typhimurium). A strain of Salmonella typhimurium is causing serious bacteremic infections in tropical Africa [7].

Salmonella typhi and paratyphi give rise to typhoid fever, which is a serious systemic disease with relatively high mortality rates. There are only a few hundred cases in the USA per year, mainly in travelers, but there are about 21 million infections per year in developing countries [8].

• Generalized Lymphadenopathy

  This patient had continuous high fever for one month, bronchopneumonia, pancytopenia, mucous bloody diarrhea and generalized lymphadenopathy. [ncbi.nlm.nih.gov]

• Splenomegaly

  […] strains of S. typhimurium and S. enteritidis) which have a high burden amongst immunocompromised or malnourished individuals, and results in bacteriemia, systemic febrile disease, and variable manifestations including lower respiratory tract infection and splenomegaly [orpha.net]

• Fever

  The symptoms of salmonella enteritis are abdominal pain, diarrhea, fever, nausea, and vomiting. [symptoma.com]

  Enteric fever remains a major health problem in the developing world, including Pakistan. Poor sanitation and hygienic conditions are the major predisposing factors. [ncbi.nlm.nih.gov]

  Enteric fever is a less severe form than typhoid ; it is characterized by fever, prostration, and septicemia. Bacteremia is relatively uncommon in patients with gastroenteritis, except in infants and the elderly. However, S. Choleraesuis, S. [merckmanuals.com]

  Typhoid fever, a more serious disease caused by Salmonella, is not common in the United States. It frequently occurs in developing countries. NIH: National Institute of Allergy and Infectious Diseases [web.archive.org]

• Chills

  We report a renal transplant recipient who presented with fever and chills for 2 days. The blood and stool cultures revealed the growth of Salmonella enteriditis. [ncbi.nlm.nih.gov]

  Heidelberg, among others, can cause a sustained and frequently lethal bacteremic syndrome lasting 1 wk, with prolonged fever, headache, malaise, and chills but rarely diarrhea. [merckmanuals.com]

  Many foodborne illnesses can be prevented by following these safe food-handling practices: cook, clean, chill and separate. You can report any concerns about restaurant food to your local inspection authority. [inspection.gc.ca]

  You have chills, a cough, or feel weak and achy. Your diarrhea or vomiting gets worse. You are dizzy or weak. You have questions or concerns about your condition or care. When should I seek immediate care or call 911? You have severe abdominal pain. [drugs.com]

• Veterinarian

  Pediatricians, veterinarians, and pet store owners should inform their patients and customers of the potential risks of owning reptiles and provide appropriate preventive education. [ncbi.nlm.nih.gov]

  Pediatricians, veterinarians, and pet store owners should inform their patients and customers of the potential risks of owning reptiles and provide appropriate preventive education. antibiotics Salmonella Marina infant pediatric Received January 24, 1996 [doi.org]

  Pet-store owners, health-care providers, and veterinarians should provide information and prevention messages about salmonellosis to owners and potential purchasers of reptiles and amphibians. [cdc.gov]

  But some smaller processors were reluctant to follow suit, said Jacob Roland Pedersen, lead veterinarian and senior manager of Danpo. [oregonlive.com]

• Reiter's Syndrome

  Complications Reiter's Syndrome While most people recover successfully from salmonella, a few may develop a chronic condition called Reiter's syndrome. This syndrome can last for months or years and can lead to arthritis. [health24.com]

  Jones M.B., Smith P.W., Olnhansen R.W.: Reiter's syndrome after Salmonella infection: occurence in HLA-B27 positive brothers. Arthritis Rheum. 1979, 22: 1141–1142. Google Scholar 13. [link.springer.com]

  Reiter's syndrome and reactive arthritis in perspective. N Engl J Med. 1983;309:1606–15. 3. Ruppert GB, Lindsay J, Barth WF. Cardiac conduction abnormalities in Reiter's syndrome. Am J Med. 1982;73:335–40. 4. Keat A. [aafp.org]

  The result is an autoimmune disease cause Reiter’s Syndrome, which produces chronic joint pain (arthritis), eye irritation (conjunctivitis with or without iritis) and problems with urination (urethritis). [livestrong.com]

  This is called Reiter's syndrome. It can last for months or years and can lead to chronic arthritis that is difficult to treat. [ Top of Page ] Q. How do people get salmonellosis? A. [web.archive.org]

• Malaise

  Heidelberg, among others, can cause a sustained and frequently lethal bacteremic syndrome lasting 1 wk, with prolonged fever, headache, malaise, and chills but rarely diarrhea. [merckmanuals.com]

• Diarrhea

  Diarrhea was absent in one-third of cases. Among 12 recipients of allogeneic HSCT, 8 presented with bacteremia and only 6 had diarrhea. A total of 9 of these 12 patients had chronic GVHD. [ncbi.nlm.nih.gov]

  Symptoms may be diarrhea, high fever with prostration, or symptoms of focal infection. Diagnosis is by cultures of blood, stool, or site specimens. [merckmanuals.com]

• Vomiting

  By the fourth day of hospital admission the patient's abdomen was distended in the absence of pain, nausea or vomiting. An abdominal radiograph showed marked gastric dilatation with no evidence of obstruction or ileus. [ncbi.nlm.nih.gov]

  Symptoms include Fever Diarrhea Abdominal cramps Headache Possible nausea, vomiting, and loss of appetite Symptoms usually last 4-7 days. Your health care provider diagnoses the infection with a stool test. Most people get better without treatment. [web.archive.org]

  Your diarrhea or vomiting gets worse. You are dizzy or weak. You have questions or concerns about your condition or care. When should I seek immediate care or call 911? You have severe abdominal pain. [drugs.com]

  Symptoms include: Fever Stomach cramps Diarrhea Vomiting Nausea Diagnosing Salmonella infection A healthcare provider takes a sample of your stool and checks for Salmonella. More than one stool sample may be needed. [saintlukeskc.org]

• Nausea

  By the fourth day of hospital admission the patient's abdomen was distended in the absence of pain, nausea or vomiting. An abdominal radiograph showed marked gastric dilatation with no evidence of obstruction or ileus. [ncbi.nlm.nih.gov]

  Symptoms include Fever Diarrhea Abdominal cramps Headache Possible nausea, vomiting, and loss of appetite Symptoms usually last 4-7 days. Your health care provider diagnoses the infection with a stool test. Most people get better without treatment. [web.archive.org]

  The symptoms of salmonella enteritis are abdominal pain, diarrhea, fever, nausea, and vomiting. [symptoma.com]

• Abdominal Pain

  A 52-year-old woman presented to our hospital with the chief complaint of left abdominal pain for 1 day. The plain kidney-ureter-bladder film and abdominal computed tomography scan showed foreign bodies in the peritoneum. [ncbi.nlm.nih.gov]

• Food Poisoning

  From Wikidata Jump to navigation Jump to search infection caused by Salmonella bacteria Enteric paratyphosis Salmonella food poisoning Salmonella food poisoning (disorder) Salmonella gastroenteritis Salmonella gastroenteritis (disorder) Salmonella gastroenteritis [wikidata.org]

  Salmonellosis (Salmonella enterocolitis; food poisoning) is an infection of the lining of the small intestine caused by the bacteria Salmonella. Statistics on Salmonella infection In the U.S. approxiamatley 40,000 people are infected each year. [myvmc.com]

  Some people can have foodborne illness, also known as "food poisoning", and not even know they have it. Many people experience nausea, vomiting and diarrhea. You should see a doctor as soon as possible if you think you have a foodborne illness. [inspection.gc.ca]

  Six food handlers at its factory and two at its outlet tested positive for Salmonella Enteritidis, a bacteria that causes food poisoning. [web.archive.org]

• Hypotension

  Acute abdomen and hypotensive shock developed suddenly without warning signs in advance. Image and tissue culture confirmed the diagnosis. The patient had an uneventful recovery. The rare clinical scenario is reported. [ncbi.nlm.nih.gov]

• Headache

  Symptoms include Fever Diarrhea Abdominal cramps Headache Possible nausea, vomiting, and loss of appetite Symptoms usually last 4-7 days. Your health care provider diagnoses the infection with a stool test. Most people get better without treatment. [web.archive.org]

  Symptoms include: Fever Diarrhea Abdominal cramps Headache Possible nausea, vomiting and loss of appetite Symptoms usually last four to seven days. Your healthcare provider diagnoses the infection with a stool test. [wexnermedical.osu.edu]

  Heidelberg, among others, can cause a sustained and frequently lethal bacteremic syndrome lasting 1 wk, with prolonged fever, headache, malaise, and chills but rarely diarrhea. [merckmanuals.com]

• Dizziness

  You are dizzy or weak. You have questions or concerns about your condition or care. When should I seek immediate care or call 911? You have severe abdominal pain. Your abdomen is tender and hard, or feels swollen. [drugs.com]

  You have signs of dehydration (thirst, dizziness, lightheadedness). You have recently traveled to a foreign country and developed diarrhea. Your diarrhea does not get better in 5 days, or it gets worse. You have severe abdominal pain. [medlineplus.gov]

Enteritis is diagnosed by culturing the organisms from the stool, whereas bacteremic samples are obtained from blood or other extraintestinal sites. Samples are plated on several media (both nonselective and selective), often with initial growth on enrichment media. Metabolic characteristics of the organism are further examined in various media such as triple sugar iron agar. Group assignment of Salmonellae is based on antigenic analysis. S. Typhimurium, for example, belongs to group B. Pulsed-field gel electrophoresis (PFGE) and multiple locus variable number tandem repeat analysis are also used to determine the infecting organism.

Culturing and then examining the bacteria by immunological and biochemical methods is work-intensive. Identifying the bacterial species based on their proteome using mass spectrometry methods [9] is a newer, simpler method. Syndromic panels, using multiplexed nucleic acid tests, are also in use [10] [11]. Whether these methods will completely replace bacterial cultures is questionable, because without cultures no biological testing (for example antimicrobial resistance assays) can be performed. Ultrasonography may serve to distinguish salmonellosis – or other types of enteritis – from Crohn's disease.

The diagnosis of typhoid fever is difficult, as blood cultures and the standard immunological test, the Widal test, are not sufficiently sensitive or specific [12]. Newer immunological assays, and nested polymerase chain reactions [13] may offer faster and more specific diagnosis.

In the USA, Salmonella infections are reportable. Clinical laboratories submit samples to state agencies from where questionable strains are sent to the Centers for Disease Control and Prevention (CDC).

• Anterior Mediastinal Mass

  Radiologically he had a large lobulated anterior mediastinal mass with necrotic thick enhancing septaes. Histopathology of the mass was suggestive of thymoma and culture from the necrotic aspirate yielded Salmonella typhi. [ncbi.nlm.nih.gov]

• Mural Thrombus

  We describe a case of salmonella infection of a left ventricular aneurysm with a mural thrombus and review 12 cases described in the literature. [ncbi.nlm.nih.gov]

• Colitis

  Using a Salmonella-colitis mouse model and cultured colonic epithelial cells, we found that pathogenic Salmonella colonization significantly increases the levels of claudin-2 protein and mRNA in the intestine, but not that of claudin-3 or claudin-7 in [ncbi.nlm.nih.gov]

  unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Infectious colitis NOS Infectious enteritis NOS Infectious gastroenteritis NOS Type 1 Excludes colitis NOS ( K52.9 ) diarrhea NOS ( R19.7 ) enteritis NOS ( K52.9 ) gastroenteritis [icd10data.com]

  In patients with gastroenteritis, stool specimens stained with methylene blue often show WBCs, indicating inflammatory colitis. [merckmanuals.com]

  In the pediatric setting, a high prevalence of Clostridium difficile was seen in both active and inactive Crohn's disease and ulcerative colitis patients. [doi.org]

• HLA-B27

  Human leucocyte antigen (HLA)-B27 was positive in 42% of patients with ReA. The Salmonella O antigens of the 496 subjects belonged to eight groups (B, C, D1, E, G, I, L, and O), all with different major O antigenic determinants. [ncbi.nlm.nih.gov]

  Aho, K., Ahuonen P., Alkio P.: HLA-B27 in reactive arthritis following infection. Ann. Rheum. Dis. 1975, 34 (suppl.), 29–31. Google Scholar 15. [link.springer.com]

  Over two thirds of these patients are HLA-B27 positive. [aafp.org]

1. Popoff MY, Bockemühl J, Brenner FW. Supplement 1999 (no. 43) to the Kauffmann-White scheme. Res Microbiol. 2000 Dec;151(10):893-896.
2. Behravesh CB, Ferraro A, Deasy M 3rd, et al, and the Salmonella Schwarzengrund Outbreak Investigation Team. Human Salmonella infections linked to contaminated dry dog and cat food, 2006-2008. Pediatrics. 2010 Sep;126(3):477-483.
3. Jones TF, Ingram LA, Fullerton KE, et al. A case-control study of the epidemiology of sporadic Salmonella infection in infants. Pediatrics. 2006 Dec;118(6):2380-2387.
4. Bavishi C, Dupont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. Aliment Pharmacol Ther. 2011 Dec;34(11-12):1269-1281.
5. Humphries RM, Linscott AJ. Laboratory diagnosis of bacterial gastroenteritis. Clin Microbiol Rev. 2015 Jan;28(1):3-31.
6. Shimoni Z, Pitlik S, Leibovici L, et al. Nontyphoid Salmonella bacteremia: age-related differences in clinical presentation, bacteriology, and outcome. Clin Infect Dis. 1999 Apr;28(4):822-827.
7. Feasey NA, Dougan G, Kingsley RA, Heyderman RS, Gordon MA. Invasive non-typhoidal salmonella disease: an emerging and neglected tropical disease in Africa. Lancet. 2012;379:2489–2499.
8. Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ. 2004 May;82(5):346-353.
9. He Y, Li H, Lu X, Stratton CW, Tang YW. Mass spectrometry biotyper system identifies enteric bacterial pathogens directly from colonies grown on selective stool culture media. J Clin Microbiol. 2010 Nov;48(11):3888-3892.
10. Buchan BW, Olson WJ, Pezewski M, et al. Clinical evaluation of a real-time PCR assay for identification of Salmonella, Shigella, Campylobacter (Campylobacter jejuni and C. coli), and shiga toxin-producing Escherichia coli isolates in stool specimens. J Clin Microbiol. 2013 Dec;51(12):4001-4007.
11. Wessels E, Rusman LG, van Bussel MJ, Claas EC. Added value of multiplex Luminex Gastrointestinal Pathogen Panel (xTAG® GPP) testing in the diagnosis of infectious gastroenteritis. Clin Microbiol Infect. 2014 Mar;20(3):O182-O187.
12. Bhutta ZA. Current concepts in the diagnosis and treatment of typhoid fever. BMJ. 2006 Jul;333:78-82.
13. Shirakava T, Acarya B, Kinoshita S, et al. Decreased susceptibility to fluoroquinolones and gyrA gene mutation in the Salmonella enterica serovar Typhi and Paratyphi A isolated in Kathmandu, Nepal, in 2003. Diagn Microbiol Infect Dis. 2006 Apr;54:299-303.