Summary
Definition
History and exam
Key diagnostic factors
- nausea/vomiting
- diarrhea
- fever
Other diagnostic factors
- myalgias
- headache
- abdominal tenderness
- signs of volume depletion
- hyperactive bowel sounds
- family history of Salmonella infection
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
Diagnostic tests
1st tests to order
- stool studies
Tests to consider
- blood cultures
- imaging studies
Treatment algorithm
gastroenteritis
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
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 DifferentialsGuidelines
- 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
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