Non-typhoidal Salmonella - Revision history

Aidan: /* Bacteremia */

2026-03-17T14:53:27Z

Bacteremia

← Older revision		Revision as of 14:53, 17 March 2026
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	* [[Ceftriaxone]] 2 g IV q24h for 7 to 14 days		* [[Ceftriaxone]] 2 g IV q24h for 7 to 14 days
		⚫	* Alternatives include [[cefotaxime]] or high-dose [[ciprofloxacin]]

⚫	*Alternatives include [[cefotaxime]] or high-dose [[ciprofloxacin]]

	=== Other Foci ===		=== Other Foci ===

Aidan at 17:12, 27 September 2024

2024-09-27T17:12:30Z

← Older revision		Revision as of 17:12, 27 September 2024
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	* [[Vascular graft infection]] or vascular prosthesis infection: as for bacteremia, for 6 weeks; remove prosthesis or graft, or do lifelong suppressive therapy		* [[Vascular graft infection]] or vascular prosthesis infection: as for bacteremia, for 6 weeks; remove prosthesis or graft, or do lifelong suppressive therapy
			* [[Aortitis]]: [[CiteRef::soravia‐dunand1999ao]]
	* [[Aortitis]]: <ref>Soravia-Dunand VA, Loo VG, Salit IE. Aortitis due to Salmonella: report of 10 cases and comprehensive review of the literature. Clin Infect Dis. 1999 Oct;29(4):862-8. doi: [https://doi.org/10.1086/520450 10.1086/520450]. PMID: [https://pubmed.ncbi.nlm.nih.gov/10589904/ 10589904].</ref>
	* [[Osteomyelitis]]: as for bacteremia, for 4+ weeks		* [[Osteomyelitis]]: as for bacteremia, for 4+ weeks
	* [[Septic arthritis]]: as for bacteremia, for 4 to 6 weeks		* [[Septic arthritis]]: as for bacteremia, for 4 to 6 weeks

Aidan: /* Endovascular Infection */

2023-08-08T21:11:31Z

Endovascular Infection

← Older revision		Revision as of 21:11, 8 August 2023
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	====Endovascular Infection====		====Endovascular Infection====

⚫	*~~Can~~ ~~cause~~ [[aortitis]], [[vascular graft infection]], and endocarditis
⚫	*Complicates up to 25% of bacteremia
	*More common in people with atherosclerosis, aortic aneurysms, prosthetic vascular grafts, valvular heart disease, and prosthetic heart valves		*More common in people with atherosclerosis, aortic aneurysms, prosthetic vascular grafts, valvular heart disease, and prosthetic heart valves
		⚫	**Most common include [[aortitis]] (particularly infrarenal abdominal aorta), [[vascular graft infection]], and [[endocarditis]]
			**Other endovascular sources are possible; pathophysiology appears to involve infection of atherosclerosis
		⚫	*Complicates up to 25% of bacteremia
	*Endovascular infection can be predicted by the [[NTSVI score]][[CiteRef::chen2012a]]		*Endovascular infection can be predicted by the [[NTSVI score]][[CiteRef::chen2012a]]
	**+1 point for each of: male sex, [[hypertension]], [[coronary artery disease]], and serogroup C1 infection		**+1 point for each of: male sex, [[hypertension]], [[coronary artery disease]], and serogroup C1 infection

Aidan at 14:37, 20 June 2023

2023-06-20T14:37:09Z

← Older revision		Revision as of 14:37, 20 June 2023
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	*Complicates up to 25% of bacteremia		*Complicates up to 25% of bacteremia
	*More common in people with atherosclerosis, aortic aneurysms, prosthetic vascular grafts, valvular heart disease, and prosthetic heart valves		*More common in people with atherosclerosis, aortic aneurysms, prosthetic vascular grafts, valvular heart disease, and prosthetic heart valves
	*Endovascular infection can be predicted by a ~~scoring~~ ~~system~~[[CiteRef::chen2012a]]		*Endovascular infection can be predicted by the [[NTSVI score]][[CiteRef::chen2012a]]
	**+1 point for each of: male ~~gender~~, hypertension, coronary artery disease, and serogroup C1 infection		**+1 point for each of: male sex, [[hypertension]], [[coronary artery disease]], and serogroup C1 infection
	**−1 point for each of: ~~immunsuppression~~ and malignancy		**−1 point for each of: immunosuppression and malignancy
	**≤1 is low-risk and ≥2 is ~~high-risk,~~ ~~giving~~ ~~a sensitivity of 95% and specificity 45%~~		**≤1 is low-risk and effectively rules out endovascular infection

	====Bone and Joint Infection====		====Bone and Joint Infection====

Aidan at 17:55, 16 December 2022

2022-12-16T17:55:03Z

← Older revision		Revision as of 17:55, 16 December 2022
Line 86:		Line 86:

	* [[Vascular graft infection]] or vascular prosthesis infection: as for bacteremia, for 6 weeks; remove prosthesis or graft, or do lifelong suppressive therapy		* [[Vascular graft infection]] or vascular prosthesis infection: as for bacteremia, for 6 weeks; remove prosthesis or graft, or do lifelong suppressive therapy
			* [[Aortitis]]: <ref>Soravia-Dunand VA, Loo VG, Salit IE. Aortitis due to Salmonella: report of 10 cases and comprehensive review of the literature. Clin Infect Dis. 1999 Oct;29(4):862-8. doi: [https://doi.org/10.1086/520450 10.1086/520450]. PMID: [https://pubmed.ncbi.nlm.nih.gov/10589904/ 10589904].</ref>
	* [[Osteomyelitis]]: as for bacteremia, for 4+ weeks		* [[Osteomyelitis]]: as for bacteremia, for 4+ weeks
	* [[Septic arthritis]]: as for bacteremia, for 4 to 6 weeks		* [[Septic arthritis]]: as for bacteremia, for 4 to 6 weeks

Aidan: /* Epidemiology */

2021-10-07T18:08:36Z

Epidemiology

← Older revision		Revision as of 18:08, 7 October 2021
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	*Numerous animal reservoirs		*Numerous animal reservoirs
	*May be transmitted by animal products (especially eggs, poultry, undercooked ground meat, dairy, or contaminated fresh produce), contaminated water exposure, and contact with animals and their environment		*May be transmitted by animal products (especially eggs, poultry, undercooked ground meat, dairy, or contaminated fresh produce), contaminated water exposure, and contact with animals and their environment (including pet hedgehogs)

	==Clinical Manifestations==		==Clinical Manifestations==

Aidan: /* Gastroenteritis */

2021-07-08T20:36:36Z

Gastroenteritis

← Older revision		Revision as of 20:36, 8 July 2021
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	**[[Ciprofloxacin]] 500 mg PO bid		**[[Ciprofloxacin]] 500 mg PO bid
	**[[Azithromycin]] 1000 mg PO on day 1 followed by 500 mg PO on days 2 to 7		**[[Azithromycin]] 1000 mg PO on day 1 followed by 500 mg PO on days 2 to 7
	**[[TMP-SMX]] SD 1 tablet PO bid		**[[TMP-SMX]] DS 1 tablet PO bid
	*Duration depends on immune status and bacteremia		*Duration depends on immune status and bacteremia
	**Immunocompetent without bacteremia: 3 to 7 days		**Immunocompetent without bacteremia: 3 to 7 days

Aidan: /* Management */

2021-05-23T18:15:26Z

Management

@@ Line 55: / Line 55: @@
 ===Asymptomatic Carriage===
 ==Management==
-*Gastroenteritis
+=== Gastroenteritis ===
-**Mild to moderate gastroenteritis: rehydration and supportive care
+*'''Mild to moderate gastroenteritis:''' rehydration and supportive care
-**Severe gastroenteritis: antibiotics
+*'''Severe gastroenteritis:''' antibiotics
-**Other indications for antibiotics include: older age >50 years, prosthetic joints, valvular heart disease, prosthetic heart vales, endovascular stents, severe atherosclerosis, active malignancy, uremia, [[sickle cell disease]], severe joint disease, immunosuppression, advanced or untreated HIV, infants <3 months
+*Other indications for antibiotics include: older age >50 years, prosthetic joints, valvular heart disease, prosthetic heart vales, endovascular stents, severe atherosclerosis, active malignancy, uremia, [[sickle cell disease]], severe joint disease, immunosuppression, advanced or untreated HIV, infants <3 months
-*Vascular prosthesis infection: as for bacteremia, for 6 weeks
+**Advanced HIV/AIDS: 2 to 6 weeks
 [[Category:Gram-negative bacilli]]

Aidan: /* Bacteremia */

2021-01-10T01:58:12Z

Bacteremia

← Older revision		Revision as of 01:58, 10 January 2021
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	{{DISPLAYTITLE:Non-typhoidal ''Salmonella''}}		{{DISPLAYTITLE:Non-typhoidal ''Salmonella''}}

	== Background ==		==Background==

	* Serotypes of [[Salmonella enterica]] that exclude Typhi and Paratyphi, which cause [[Enteric fever\|typhoid fever]]		*Serotypes of [[Salmonella enterica]] that exclude Typhi and Paratyphi, which cause [[Enteric fever\|typhoid fever]]

	=== Epidemiology ===		===Epidemiology===

	* Numerous animal reservoirs		*Numerous animal reservoirs
	* May be transmitted by animal products (especially eggs, poultry, undercooked ground meat, dairy, or contaminated fresh produce), contaminated water exposure, and contact with animals and their environment		*May be transmitted by animal products (especially eggs, poultry, undercooked ground meat, dairy, or contaminated fresh produce), contaminated water exposure, and contact with animals and their environment

	== Clinical Manifestations ==		==Clinical Manifestations==

	=== Gastroenteritis ===		===Gastroenteritis===

	* One of the most common causes of foodborne illness		*One of the most common causes of foodborne illness
	* Incubation period [[Usual incubation period::6 to 48 hours]] (range [[Incubation period range::up to 7 days]])		*Incubation period [[Usual incubation period::6 to 48 hours]] (range [[Incubation period range::up to 7 days]])
	* Diarrhea, abdominal pain, nausea and vomiting, fevers and chillds		*Diarrhea, abdominal pain, nausea and vomiting, fevers and chillds
	** Stools are usually loose but can be profuse and watery ("cholera-like") or small volume but with tenesmus ("dysentery-like")		**Stools are usually loose but can be profuse and watery ("cholera-like") or small volume but with tenesmus ("dysentery-like")
	* May have headaches and myalgias		*May have headaches and myalgias
	* Can mimic [[appendicitis]] (from [[mesenteric adenitis]]) and [[inflammatory bowel disease]]		*Can mimic [[appendicitis]] (from [[mesenteric adenitis]]) and [[inflammatory bowel disease]]
	* Self-limited, lasting 3 to 7 days		*Self-limited, lasting 3 to 7 days

	=== Extraintestinal Manifestations ===		===Extraintestinal Manifestations===

	==== Bacteremia ====		====Bacteremia====

	* Most common extraintestinal site, in up to 8% of cases of NTS gastroenteritis		*Most common extraintestinal site, in up to 8% of cases of NTS gastroenteritis
	* More common in older patients >65 years, immunocompromised hosts, and patients with [[hemoglobinopathies]]		*More common in older patients >65 years, immunocompromised hosts, and patients with [[hemoglobinopathies]] (particularly [[sickle cell disease]])

	==== Endovascular Infection ====		====Endovascular Infection====

	* Can cause [[aortitis]], [[vascular graft infection]], and endocarditis		*Can cause [[aortitis]], [[vascular graft infection]], and endocarditis
	* Complicates up to 25% of bacteremia		*Complicates up to 25% of bacteremia
	* More common in people with atherosclerosis, aortic aneurysms, prosthetic vascular grafts, valvular heart disease, and prosthetic heart valves		*More common in people with atherosclerosis, aortic aneurysms, prosthetic vascular grafts, valvular heart disease, and prosthetic heart valves
	* Endovascular infection can be predicted by a scoring system[[CiteRef::chen2012a]]		*Endovascular infection can be predicted by a scoring system[[CiteRef::chen2012a]]
	** +1 point for each of: male gender, hypertension, coronary artery disease, and serogroup C1 infection		**+1 point for each of: male gender, hypertension, coronary artery disease, and serogroup C1 infection
	** −1 point for each of: immunsuppression and malignancy		**−1 point for each of: immunsuppression and malignancy
	** ≤1 is low-risk and ≥2 is high-risk, giving a sensitivity of 95% and specificity 45%		**≤1 is low-risk and ≥2 is high-risk, giving a sensitivity of 95% and specificity 45%

	==== Bone and Joint Infection ====		====Bone and Joint Infection====

	* Can cause [[osteomyelitis]], especially in [[sickle cell disease]], as well as [[septic arthritis]]		*Can cause [[osteomyelitis]], especially in [[sickle cell disease]], as well as [[septic arthritis]]
	* Can also cause a [[reactive arthritis]] characterized by lower-limb [[acute arthritis]], [[urethritis]], and [[conjunctivitis]]		*Can also cause a [[reactive arthritis]] characterized by lower-limb [[acute arthritis]], [[urethritis]], and [[conjunctivitis]]

	==== Genitourinary Infection ====		====Genitourinary Infection====

	* Can rarely cause [[urinary tract infection]]		*Can rarely cause [[urinary tract infection]]
	* May be secondary to [[bacteremia]]		*May be secondary to [[bacteremia]]

	==== Meningitis ====		====Meningitis====

	* More common in infants		*More common in infants

	=== Asymptomatic Carriage ===		===Asymptomatic Carriage===

	* Some people chronically shed bacteria in stool for >1 year		*Some people chronically shed bacteria in stool for >1 year
	* Less than 1%		*Less than 1%

	== Management ==		==Management==

	* Gastroenteritis		*Gastroenteritis
	** Mild to moderate gastroenteritis: rehydration and supportive care		**Mild to moderate gastroenteritis: rehydration and supportive care
	** Severe gastroenteritis: antibiotics		**Severe gastroenteritis: antibiotics
	** Other indications for antibiotics include: older age >50 years, prosthetic joints, valvular heart disease, prosthetic heart vales, endovascular stents, severe atherosclerosis, active malignancy, uremia, [[sickle cell disease]], severe joint disease, immunosuppression, advanced or untreated HIV, infants <3 months		**Other indications for antibiotics include: older age >50 years, prosthetic joints, valvular heart disease, prosthetic heart vales, endovascular stents, severe atherosclerosis, active malignancy, uremia, [[sickle cell disease]], severe joint disease, immunosuppression, advanced or untreated HIV, infants <3 months
	** Options include [[ceftriaxone]] 1-2 g IV q24h, [[ciprofloxacin]] 500 mg PO bid, [[azithromycin]] 1000 mg PO on day 1 followed by 500 mg PO on days 2 to 7, and [[TMP-SMX]] SD 1 tablet PO bid		**Options include [[ceftriaxone]] 1-2 g IV q24h, [[ciprofloxacin]] 500 mg PO bid, [[azithromycin]] 1000 mg PO on day 1 followed by 500 mg PO on days 2 to 7, and [[TMP-SMX]] SD 1 tablet PO bid
	** Duration depends on immune status and bacteremia		**Duration depends on immune status and bacteremia
	*** Immunocompetent without bacteremia: 3 to 7 days		***Immunocompetent without bacteremia: 3 to 7 days
	*** Immunocompetent with bacteremia alone: 7 to 14 days		***Immunocompetent with bacteremia alone: 7 to 14 days
	*** Advanced HIV/AIDS: 2 to 6 weeks		***Advanced HIV/AIDS: 2 to 6 weeks
	*** Other immunosuppressed host: 14 or more days		***Other immunosuppressed host: 14 or more days
	* Bacteremia: [[ceftriaxone]] 2 g IV q24h for 7 to 14 days		*Bacteremia: [[ceftriaxone]] 2 g IV q24h for 7 to 14 days
	** Alternatives include [[cefotaxime]] or high-dose [[ciprofloxacin]]		**Alternatives include [[cefotaxime]] or high-dose [[ciprofloxacin]]
	* Vascular prosthesis infection: as for bacteremia, for 6 weeks		*Vascular prosthesis infection: as for bacteremia, for 6 weeks
	** Either remove prosthesis or consider lifelong suppressive therapy		**Either remove prosthesis or consider lifelong suppressive therapy
	* [[Osteomyelitis]]: as for bacteremia, for 4+ weeks		*[[Osteomyelitis]]: as for bacteremia, for 4+ weeks
	* [[Septic arthritis]]: as for bacteremia, for 4 to 6 weeks		*[[Septic arthritis]]: as for bacteremia, for 4 to 6 weeks
	* [[Endocarditis]]: as for bacteremia, for 6 weeks		*[[Endocarditis]]: as for bacteremia, for 6 weeks
	* [[Urinary tract infection]]: intravenous therapy for 1 to 2 weeks followed by oral therapy to complete 6 weeks		*[[Urinary tract infection]]: intravenous therapy for 1 to 2 weeks followed by oral therapy to complete 6 weeks
	** IV: [[ceftriaxone]], [[cefotaxime]], [[ciprofloxacin]] IV/PO		**IV: [[ceftriaxone]], [[cefotaxime]], [[ciprofloxacin]] IV/PO
	** PO: [[ciprofloxacin]] or [[TMP-SMX]]		**PO: [[ciprofloxacin]] or [[TMP-SMX]]
	* Asymptomatic carriage: no treatment, since it does not eradicate carriage but does promote resistance		*Asymptomatic carriage: no treatment, since it does not eradicate carriage but does promote resistance
	** Encourage hand hygiene		**Encourage hand hygiene

	[[Category:Gram-negative bacilli]]		[[Category:Gram-negative bacilli]]

Aidan: Created page with "{{DISPLAYTITLE:Non-typhoidal ''Salmonella''}} == Background == * Serotypes of Salmonella enterica that exclude Typhi and Paratyphi, which cause Enteric fever|typhoid f..."

2021-01-10T01:48:57Z

Created page with "{{DISPLAYTITLE:Non-typhoidal ''Salmonella''}} == Background == * Serotypes of Salmonella enterica that exclude Typhi and Paratyphi, which cause Enteric fever|typhoid f..."

New page

{{DISPLAYTITLE:Non-typhoidal ''Salmonella''}}

== Background ==

* Serotypes of [[Salmonella enterica]] that exclude Typhi and Paratyphi, which cause [[Enteric fever|typhoid fever]]

=== Epidemiology ===

* Numerous animal reservoirs
* May be transmitted by animal products (especially eggs, poultry, undercooked ground meat, dairy, or contaminated fresh produce), contaminated water exposure, and contact with animals and their environment

== Clinical Manifestations ==

=== Gastroenteritis ===

* One of the most common causes of foodborne illness
* Incubation period [[Usual incubation period::6 to 48 hours]] (range [[Incubation period range::up to 7 days]])
* Diarrhea, abdominal pain, nausea and vomiting, fevers and chillds
** Stools are usually loose but can be profuse and watery ("cholera-like") or small volume but with tenesmus ("dysentery-like")
* May have headaches and myalgias
* Can mimic [[appendicitis]] (from [[mesenteric adenitis]]) and [[inflammatory bowel disease]]
* Self-limited, lasting 3 to 7 days

=== Extraintestinal Manifestations ===

==== Bacteremia ====

* Most common extraintestinal site, in up to 8% of cases of NTS gastroenteritis
* More common in older patients >65 years, immunocompromised hosts, and patients with [[hemoglobinopathies]]

==== Endovascular Infection ====

* Can cause [[aortitis]], [[vascular graft infection]], and endocarditis
* Complicates up to 25% of bacteremia
* More common in people with atherosclerosis, aortic aneurysms, prosthetic vascular grafts, valvular heart disease, and prosthetic heart valves
* Endovascular infection can be predicted by a scoring system[[CiteRef::chen2012a]]
** +1 point for each of: male gender, hypertension, coronary artery disease, and serogroup C1 infection
** −1 point for each of: immunsuppression and malignancy
** ≤1 is low-risk and ≥2 is high-risk, giving a sensitivity of 95% and specificity 45%

==== Bone and Joint Infection ====

* Can cause [[osteomyelitis]], especially in [[sickle cell disease]], as well as [[septic arthritis]]
* Can also cause a [[reactive arthritis]] characterized by lower-limb [[acute arthritis]], [[urethritis]], and [[conjunctivitis]]

==== Genitourinary Infection ====

* Can rarely cause [[urinary tract infection]]
* May be secondary to [[bacteremia]]

==== Meningitis ====

* More common in infants

=== Asymptomatic Carriage ===

* Some people chronically shed bacteria in stool for >1 year
* Less than 1%

== Management ==

* Gastroenteritis
** Mild to moderate gastroenteritis: rehydration and supportive care
** Severe gastroenteritis: antibiotics
** Other indications for antibiotics include: older age >50 years, prosthetic joints, valvular heart disease, prosthetic heart vales, endovascular stents, severe atherosclerosis, active malignancy, uremia, [[sickle cell disease]], severe joint disease, immunosuppression, advanced or untreated HIV, infants <3 months
** Options include [[ceftriaxone]] 1-2 g IV q24h, [[ciprofloxacin]] 500 mg PO bid, [[azithromycin]] 1000 mg PO on day 1 followed by 500 mg PO on days 2 to 7, and [[TMP-SMX]] SD 1 tablet PO bid
** Duration depends on immune status and bacteremia
*** Immunocompetent without bacteremia: 3 to 7 days
*** Immunocompetent with bacteremia alone: 7 to 14 days
*** Advanced HIV/AIDS: 2 to 6 weeks
*** Other immunosuppressed host: 14 or more days
* Bacteremia: [[ceftriaxone]] 2 g IV q24h for 7 to 14 days
** Alternatives include [[cefotaxime]] or high-dose [[ciprofloxacin]]
* Vascular prosthesis infection: as for bacteremia, for 6 weeks
** Either remove prosthesis or consider lifelong suppressive therapy
* [[Osteomyelitis]]: as for bacteremia, for 4+ weeks
* [[Septic arthritis]]: as for bacteremia, for 4 to 6 weeks
* [[Endocarditis]]: as for bacteremia, for 6 weeks
* [[Urinary tract infection]]: intravenous therapy for 1 to 2 weeks followed by oral therapy to complete 6 weeks
** IV: [[ceftriaxone]], [[cefotaxime]], [[ciprofloxacin]] IV/PO
** PO: [[ciprofloxacin]] or [[TMP-SMX]]
* Asymptomatic carriage: no treatment, since it does not eradicate carriage but does promote resistance
** Encourage hand hygiene

[[Category:Gram-negative bacilli]]