Salmonellosis natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
The symptoms of salmonellosis may occur at any age, and typically develop after 6 to 72 hours after [[ingestion]] of the contaminated food. The [[inoculum]] responsible for the disease is often greater 50000 [[Salmonella|bacteria]]. | The symptoms of salmonellosis may occur at any age, and typically develop after 6 to 72 hours after [[ingestion]] of the contaminated food. The [[inoculum]] responsible for the disease is often greater 50000 [[Salmonella|bacteria]]. | ||
Commonly salmonellosis affects the ileum, however, it may also occur in the large bowel (non-typhoyd). The stomach, duodenum and jejunum are commonly spared of inflammation.<ref name="pmid17146467">{{cite journal| author=Coburn B, Grassl GA, Finlay BB| title=Salmonella, the host and disease: a brief review. | journal=Immunol Cell Biol | year= 2007 | volume= 85 | issue= 2 | pages= 112-8 | pmid=17146467 | doi=10.1038/sj.icb.7100007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17146467 }} </ref><ref name="pmid534385">{{cite journal| author=McGovern VJ, Slavutin LJ| title=Pathology of salmonella colitis. | journal=Am J Surg Pathol | year= 1979 | volume= 3 | issue= 6 | pages= 483-90 | pmid=534385 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=534385 }} </ref><ref name="pmid3896961">{{cite journal| author=Boyd JF| title=Pathology of the alimentary tract in Salmonella typhimurium food poisoning. | journal=Gut | year= 1985 | volume= 26 | issue= 9 | pages= 935-44 | pmid=3896961 | doi= | pmc=PMC1432849 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3896961 }} </ref> | Salmonellosis may occur at any age, and start with [[symptoms]] that are indistinguishable from those caused by other [[gastrointestinal]] pathogens. These include acute onset of [[nausea]], [[vomiting]], crampy [[abdominal pain]], fever (38-39ºC) and [[diarrhea]]. Diarrhea may be simply nonbloody, loose stools, in moderate volume, or may be a large volume of watery, bloody stools. Children with enterocolitic [[infection]] often present with severe [[inflammatory disease]], with [[bloody diarrhea]], increased [[symptom]] duration and risk of [[complications]].<ref name="pmid17146467">{{cite journal| author=Coburn B, Grassl GA, Finlay BB| title=Salmonella, the host and disease: a brief review. | journal=Immunol Cell Biol | year= 2007 | volume= 85 | issue= 2 | pages= 112-8 | pmid=17146467 | doi=10.1038/sj.icb.7100007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17146467 }} </ref> | ||
Commonly [[salmonellosis]] affects the [[ileum]], however, it may also occur in the [[large bowel]] (non-typhoyd). The [[stomach]], [[duodenum]] and [[jejunum]] are commonly spared of [[inflammation]].<ref name="pmid17146467">{{cite journal| author=Coburn B, Grassl GA, Finlay BB| title=Salmonella, the host and disease: a brief review. | journal=Immunol Cell Biol | year= 2007 | volume= 85 | issue= 2 | pages= 112-8 | pmid=17146467 | doi=10.1038/sj.icb.7100007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17146467 }} </ref><ref name="pmid534385">{{cite journal| author=McGovern VJ, Slavutin LJ| title=Pathology of salmonella colitis. | journal=Am J Surg Pathol | year= 1979 | volume= 3 | issue= 6 | pages= 483-90 | pmid=534385 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=534385 }} </ref><ref name="pmid3896961">{{cite journal| author=Boyd JF| title=Pathology of the alimentary tract in Salmonella typhimurium food poisoning. | journal=Gut | year= 1985 | volume= 26 | issue= 9 | pages= 935-44 | pmid=3896961 | doi= | pmc=PMC1432849 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3896961 }} </ref> | |||
For the [[infections]] limited to the [[gastrointestinal tract]], in the absence of treatment, [[symptoms]] commonly have a spontaneous resolution within 5 to 7 days.<ref name="pmid17146467">{{cite journal| author=Coburn B, Grassl GA, Finlay BB| title=Salmonella, the host and disease: a brief review. | journal=Immunol Cell Biol | year= 2007 | volume= 85 | issue= 2 | pages= 112-8 | pmid=17146467 | doi=10.1038/sj.icb.7100007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17146467 }} </ref> | For the [[infections]] limited to the [[gastrointestinal tract]], in the absence of treatment, [[symptoms]] commonly have a spontaneous resolution within 5 to 7 days.<ref name="pmid17146467">{{cite journal| author=Coburn B, Grassl GA, Finlay BB| title=Salmonella, the host and disease: a brief review. | journal=Immunol Cell Biol | year= 2007 | volume= 85 | issue= 2 | pages= 112-8 | pmid=17146467 | doi=10.1038/sj.icb.7100007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17146467 }} </ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Jolanta Marszalek, M.D. [3]
Overview
Natural History
The symptoms of salmonellosis may occur at any age, and typically develop after 6 to 72 hours after ingestion of the contaminated food. The inoculum responsible for the disease is often greater 50000 bacteria.
Salmonellosis may occur at any age, and start with symptoms that are indistinguishable from those caused by other gastrointestinal pathogens. These include acute onset of nausea, vomiting, crampy abdominal pain, fever (38-39ºC) and diarrhea. Diarrhea may be simply nonbloody, loose stools, in moderate volume, or may be a large volume of watery, bloody stools. Children with enterocolitic infection often present with severe inflammatory disease, with bloody diarrhea, increased symptom duration and risk of complications.[1]
Commonly salmonellosis affects the ileum, however, it may also occur in the large bowel (non-typhoyd). The stomach, duodenum and jejunum are commonly spared of inflammation.[1][2][3]
For the infections limited to the gastrointestinal tract, in the absence of treatment, symptoms commonly have a spontaneous resolution within 5 to 7 days.[1]
For adults, antibiotic treatment is only indicated in certain conditions, mentioned in medical therapy. For these cases, the treatment does not decrease severity nor the duration of symptoms.[1]
Complications
Persons with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal. A small number of persons with Salmonella develop pain in their joints, irritation of the eyes, and painful urination. This is called Reiter's syndrome. It can last for months or years, and can lead to chronic arthritis which is difficult to treat. Antibiotic treatment does not make a difference in whether or not the person develops arthritis.
Prognosis
Persons with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal. A small number of persons who are infected with Salmonella, will go on to develop pains in their joints, irritation of the eyes, and painful urination. This is called Reiter's syndrome. It can last for months or years, and can lead to chronic arthritis which is difficult to treat. Antibiotic treatment does not make a difference in whether or not the person later develops arthritis.[4]
References
- ↑ 1.0 1.1 1.2 1.3 Coburn B, Grassl GA, Finlay BB (2007). "Salmonella, the host and disease: a brief review". Immunol Cell Biol. 85 (2): 112–8. doi:10.1038/sj.icb.7100007. PMID 17146467.
- ↑ McGovern VJ, Slavutin LJ (1979). "Pathology of salmonella colitis". Am J Surg Pathol. 3 (6): 483–90. PMID 534385.
- ↑ Boyd JF (1985). "Pathology of the alimentary tract in Salmonella typhimurium food poisoning". Gut. 26 (9): 935–44. PMC 1432849. PMID 3896961.
- ↑ http://www.cdc.gov/ncidod/dbmd/diseaseinfo/salmonellosis_g.htm