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Salmonellosis

Last reviewed: 1 Apr 2025
Last updated: 05 Dec 2023

Summary

Definition

History and exam

Key diagnostic factors

  • nausea/vomiting
  • diarrhea
  • fever
Full details

Other diagnostic factors

  • myalgias
  • headache
  • abdominal tenderness
  • signs of volume depletion
  • hyperactive bowel sounds
  • family history of Salmonella infection
Full details

Risk factors

  • food exposures
  • extremes of age (<12 months and >50 years)
  • presence of an immunosuppressive state
  • low gastric acidity
  • exposure to symptomatic person with Salmonella
  • animal contact
  • use of antibiotics
  • poorly controlled diabetes mellitus
  • chronic granulomatous disease
  • iron overload
  • malnutrition
Full details

Diagnostic tests

1st tests to order

  • stool studies
Full details

Tests to consider

  • blood cultures
  • imaging studies
Full details

Treatment algorithm

ACUTE

gastroenteritis

ONGOING

chronic carrier state

Contributors

Authors

Ferric C. Fang, MD

Professor of Laboratory Medicine, Pathology, and Microbiology

Adjunct Professor of Medicine (Infective Diseases)

University of Washington School of Medicine

Seattle

WA

Disclosures

FCF is a consultant for bioMérieux and a member of the SaNOtize scientific advisory board, and an author of references cited in this topic.

Acknowledgements

Dr Ferric C. Fang would like to gratefully acknowledge Dr William A. Petri, Dr Michael Preziosi, Dr Joshua Fierer, and Dr Nancy F. Crum-Cianflone, previous contributors to this topic.

Disclosures

JF and NFCC are authors of references cited in this topic. WAP and MP declare that they have no competing interests.

Peer reviewers

David Acheson, MD

Chief Medical Officer

Director of Food Safety and Security

US Food and Drug Administration

Rockville

MD

Disclosures

DA declares that he has no competing interests.

Timothy Jones, MD

Deputy State Epidemiologist

Communicable and Environmental Disease Services

Tennessee Department of Health

Nashville

TN

Disclosures

TJ declares that he has no competing interests.

Franz Allerberger, MD, MPH

Head of Division

Division for Public Health

Austrian Agency for Health & Food Safety

Vienna

Austria

Disclosures

FA declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Delahoy MJ, Shah HJ, Weller DL, et al. Preliminary incidence and trends of infections caused by pathogens transmitted commonly through food - foodborne diseases active surveillance network, 10 U.S. sites, 2022. MMWR Morb Mortal Wkly Rep. 2023 Jun 30;72(26):701-6.Full text  Abstract

Pegues DA, Miller SI. Salmonella species, including Salmonella Typhi. In: Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 7th ed. Philadelphia, PA: Churchill Livingstone; 2010:2887-903.

Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):1963-73.Full text  Abstract

Riddle MS, DuPont HL, Connor BA. ACG Clinical guideline: diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016 May;111(5):602-22. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

    • Shigellosis
    • Campylobacter species infection
    • Yersiniosis
    More Differentials
  • Guidelines

    • 2017 Infectious Disease Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea
    • Compendium of measures to prevent disease associated with animals in public settings
    More Guidelines
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