PEARLS
- Nontyphoidal salmonellae cause gastroenteritis, which is usually a self-limited illness lasting 3–7 days but which may be complicated by bacteremia and or localized extraintestinal infection.
- Most commonly, nontyphoidal salmonellosis is acquired through ingestion of contaminated water and food products, such as eggs, poultry, undercooked meat, unpasteurized dairy products, seafood, and fresh produce. Infection may also be acquired through exposure to reptiles.
- Risk factors for severe illness include extremes of age, underlying sickle cell disease, hemoglobinopathies, and preexisting bone disease (for osteomyelitis).
- Diagnosis is made by stool culture, which may remain positive for 4–5 weeks or longer after acute infection.
- Antibiotic treatment is not recommended in most cases of nontyphoidal salmonellosis.
- For patients with indications for treatment of gastroenteritis (infants, elderly patients, immunocompromised patients), fluoroquinolones or third-generation cephalosporins may be given.
- Routine follow-up cultures are not recommended for most patients, but detection and eradication of Salmonella in the stool of patients with chronic carriage may be appropriate in specific populations, such as immunocompromised hosts, food handlers, health care workers, and day-care center affiliates.
- Careful oversight of commercial and personal food preparation, including an effort to cook and/or pasteurize egg products, is strongly recommended in order to prevent infection.
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