 Salmonella enterocolitis
Definition Alternative Names Causes, incidence, and risk factors Symptoms Signs and tests Treatment Expectations (prognosis) Complications Calling your health care provider Prevention References DefinitionSalmonella enterocolitis is an infection in the lining of the small intestine caused by Salmonella bacteria. Alternative NamesSalmonellosis Causes, incidence, and risk factorsSalmonella enterocolitis is one of the most common types of food poisoning. It occurs when you swallow food or water that is contaminated with the salmonella bacteria. Any food can become contaminated if food preparation conditions and equipment are unsanitary. You are more likely to get this type of infection if you have: - Eaten improperly prepared or stored food (especially undercooked turkey or chicken, unrefrigerated turkey dressing, undercooked eggs)
- Family members with recent salmonella infection
- Had a recent family illness with gastroenteritis
- Been in an institution
- Eaten chicken recently
- A pet iguana or other lizards, turtles, or snakes (reptiles are carriers of salmonella)
- A weakened immune system
Approximately 40,000 people develop salmonella infection in the United States each year. Most patients are younger than 20. The highest rate occurs from July through October. SymptomsThe time between infection and symptom development is 8 - 48 hours. Symptoms include: Signs and testsThe doctor will perform a physical exam. You may have signs of a tender abdomen and tiny pink spots on the skin called rose spots. Tests that may be done include: TreatmentThe goal of treatment is to replace fluids and electrolytes lost by diarrhea. Electrolyte solutions are available without a prescription. Antidiarrheal medications are generally not given because they may prolong the infection. If you have severe symptoms, your doctor may prescribe antibiotics. People with diarrhea who are can't drink anything due to nausea may need medical attention and intravenous fluids. This is especially true for small children. Fever and aches can be treated with acetaminophen or ibuprofen. If you take diuretics, you may need to stop taking them during the acute episode, when diarrhea is present. Ask your health care provider for instructions. Changing your diet while you have diarrhea may help reduce symptoms. This may include avoiding milk products and following a BRAT diet. BRAT stands for bananas, rice, applesauce, and toast. These are binding foods that make the stools firmer. Infants should continue to breastfeed and receive electrolyte replacement solutions as directed by your health care provider. Expectations (prognosis)The outcome is usually good. In otherwise healthy people, symptoms should go away in 2 - 5 days. The acute illness lasts for 1 - 2 weeks. The bacteria is shed in the feces for months in some treated patients. Some people who shed the bacteria have a carrier state for 1 year or more after the infection. ComplicationsDehydration from diarrhea, especially in young children and infants, is a dangerous complication. Life-threatening meningitis and septicemia may also occur. Food handlers who become carriers can pass the infection along to the people who eat their food. Calling your health care providerCall your health care provider if there is blood in the stools, or if there is no improvement after 2-3 days. Also call if any of the following occurs: - Severe vomiting or abdominal pain
- Signs of dehydration: decreased urine output, sunken eyes, sticky or dry mouth, no tears when crying
- Unresponsiveness
PreventionProper food handling and storage can help prevent Salmonella enterocolitis. Good hand washing is important, especially when handling eggs and poultry. If you own a reptile, wear gloves when handling the animal or its feces because animals can easily pass Salmonella to humans. ReferencesPegues DA, Miller SI. Salmonella Species, including Salmonella Typhi. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 223. Giannella RA. Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap 104. Physician ReferenceInternational Classification of Diseases, 9th Revision (ICD9)003.0
Review Date: 5/25/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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