Crampy Abdominal Pain (see Abdominal Pain, [[Abdominal Pain]])
Diarrhea (see Diarrhea, [[Diarrhea]]): not usually grossly bloody (although bloody stools can be seen, particularly in childhood cases) (see Gastrointestinal Hemorrhage, [[Gastrointestinal Hemorrhage]])
Antibiotic Therapy is Indicated in Patients with Severe Disease (>9-10 Stools/Day, High Fever, or Need for Hospitalization) or in Patients with Risk Factors for Invasive Disease (Immunocompromised, Endovascular or Osseous Prostheses, etc)
Antibiotic Therapy is Generally Not Indicated for Immunocompetent Patients Between 12-50 y/o with Mild-Moderate Symptoms
Meta-Analysis (Cochrane Database Syst Rev, 2012) [MEDLINE]: no benefit of antibiotic therapy in otherwise healthy patients with mild-moderate Salmonella gastroenteritis, in terms of duration of illness, diarrhea, or fever
Fluoroquinolones (see Fluoroquinolones, [[Fluoroquinolones]]): typically used agents
Antibiotic Therapy May Theoretically Increase the Risk for Extending the Period of Asymptomatic Salmonella Carriage
Prognosis: 0.5-1% (although these are likely overestimates, due to milder cases not being reported)
Bacteremia with Invasive Disease
General Comments
Bacteremia Develops in <5% of Patients with Salmonella Gastroenteritis
Bacteremia Leads to a Variety of Extraintestinal Manifestations
Bacteremia/Invasiveness is More Commonly Observed with Salmonella Choleraesuis, Salmonella Heidelberg, and Antibiotic-Resistant Strains of Salmonella Typhimurium
Aortitis/Arteritis
Epidemiology
Increased Risk in Adults >50 y/o with Known Atherosclerotic Disease
Approximately 10% of Adults >50 y/o Diagnosed with Non-Typhoidal Salmonella Bacteremia Will Develop Infective Arteritis
