Nontyphoidal Salmonella species colonize the GI tract of many animals, including birds.
Up to 80% of chicken eggs are contaminated with this gram-negative bacterium.
Spread of nontyphoidal Salmonella to humans is much more common from poultry, poultry products, and pet reptiles than pet birds. Infected birds may be halthy carriers.
Gastroenteritis in humans begin with nausea, vomiting, fever, and non bloody darrhea about 48h after ingestion. Most infections are self limited, with resolution of fever within 48 to 72 h, and resolution of diarrhea within 4-10 days. Systemic infections is more likely in immunosuppressed patients, sickle cell patients, malignant neoplasms, chronic GI tract disease.
Systemic nontyphoidal salmonella may settle in existing fractures, DJD, abnormal lung tissue, organs affected by stones.
Large vessel arteritis should be suspected in person at risk who presents with back, chest, or abdominal pain preceded by gastroenteritis.
Diagnosic tests: stool culture, blood culture if extraintestinal or systemic infections.
Treatment:
Diarrhea is usually self limited.
Antibiotic treatment increases carrier rate.
Ciprofloxacin, ceftriaxone, or TMP/SMX.
In HIV/AIDS: IV quinolones for 1-2 weeks, then orally for 4 weeks.
For those with endovascular infection: IV 3rd gen cephalosporin or parenteral ampicillin for 6 wks.
MICROBIOLOGY:
Part of the Enterobacteriaceae.
Salmonella are found virtually in all animals.
Serotypes such as S. typhi and S. paratyphi are highly adapted to humans and do not cause disease in nonhuman hosts. Other strains (e.g. S. choleraesuis) are adapted to animals, when they infect human, can cause severe disease.
A large inoculum is required for symptomatic disease. The infectious dose is reduced for people at increased risk of for disease because of age, immunosuppression, or underlying disease (leukemia, lymphoma, sickle cell disease) or reduced gastric acidity.
