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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 3. Summaries of Infectious Diseases
Salmonella Infections
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Nontyphoidal Salmonella organisms cause asymptomatic carriage, gastroenteritis, bacteremia, and focal infections (such as meningitis and osteomyelitis). These disease categories are not mutually exclusive but represent a spectrum of illness. The most common illness associated with nontyphoidal Salmonella is gastroenteritis, in which diarrhea, abdominal cramps and tenderness, and fever are common manifestations. The site of infection usually is the small intestine, but colitis can occur. Sustained or intermittent bacteremia can occur, and focal infections are recognized in as many as 10% of patients with bacteremia resulting from Salmonella infection.
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Salmonella serotype Typhi and several other Salmonella serotypes may cause a protracted bacteremic illness referred to as enteric or typhoid fever. The onset of illness typically is gradual, with manifestations such as fever, constitutional symptoms (eg, headache, malaise, anorexia, and lethargy), abdominal pain and tenderness, hepatomegaly, splenomegaly, rose spots, and changes in mental status. Enteric fever may manifest as a mild, nondescript febrile illness in young children in whom sustained or intermittent bacteremia can occur. Constipation may be an early feature. Diarrhea occurs commonly in children. Recurrent Salmonella bacteremia is an acquired immunodeficiency syndrome (AIDS)-defining condition for adolescents and adults infected with the human immunodeficiency virus (HIV).
ETIOLOGY: Salmonella organisms are gram-negative bacilli that belong to the Enterobacteriaceae family. Currently, there are more than 2460 Salmonella serotypes; most that cause human disease are divided among O-antigen groups A through E. Salmonella serotype Typhi is classified in serogroup D. In 2000, the most commonly reported human isolates in the United States were Salmonella serotype Typhimurium (serogroup B), Salmonella serotype Enteritidis (D), Salmonella serotype Newport (C2), Salmonella serotype Heidelberg (B), Salmonella serotype Javiana (D), Salmonella
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