Salmonella enterocolitis

Causes

Salmonella infection is one of the most common types of food poisoning. It occurs when you swallow food or water that contains the salmonella bacteria.

The salmonella germs may get into the food you eat (called contamination) in several ways.

You are more likely to get this type of infection if you have:

• Eaten foods such as turkey, turkey dressing, chicken, or eggs that have not been cooked well or stored properly
• Family members with recent salmonella infection
• Been or worked in a hospital, nursing home, or other long-term health facility
• A pet iguana or other lizards, turtles, or snakes (reptiles are carriers of salmonella)
• A weakened immune system
• Regularly used medicines that block acid production in the stomach
• Crohn's disease or ulcerative colitis
• Used antibiotics in the recent past

Most people with this condition are younger than 20.

Symptoms

The time between infection and symptoms is 8 - 48 hours. Symptoms include:

• Abdominal pain, cramping, or tenderness
• Chills
• Diarrhea
• Fever
• Muscle pain
• Nausea
• Vomiting

Exams and Tests

The health care provider will perform a physical exam. You may have signs of a tender abdomen and tiny pink spots on the skin called rose spots.

Tests that may be done include:

• Blood culture
• Complete blood count with differential
• Febrile/cold agglutinins (test for specific antibodies)
• Stool culture for salmonella

Treatment

The goal is to make you feel better and avoid dehydration. Dehydration means your body does not have as much water and fluids as it should.

These things may help you feel better if you have diarrhea:

• Drink 8 to 10 glasses of clear fluids every day. Water is best.
• Drink at least 1 cup of liquid every time you have a loose bowel movement.
• Eat small meals throughout the day, instead of three big meals.
• Eat some salty foods, such as pretzels, soup, and sports drinks.
• Eat some high-potassium foods, such as bananas, potatoes without the skin, and watered-down fruit juices.

Give your child fluids for the first 4 to 6 hours. At first, try 1 ounce (2 tablespoons) of fluid every 30 to 60 minutes.

• Infants should continue to breastfeed and receive electrolyte replacement solutions as recommended by your health care provider.
• You can use an over-the-counter drink, such as Pedialyte or Infalyte. Do not water down these drinks.
• You can also try Pedialyte popsicles.
• Watered-down fruit juice or broth may also help.

Medicines that slow down diarrhea are usually not given because they may make the infection last longer. If you have severe symptoms, your health care provider may prescribe antibiotics.

If you take water pills or diuretics, you may need to stop taking them when you have diarrhea. Ask your health care provider.

Outlook (Prognosis)

In otherwise healthy people, symptoms should go away in 2 - 5 days, but they may last for 1 - 2 weeks.

The bacteria can be shed in the feces of some treated patients for months to a year after the infection. Food handlers who carry salmonella in their body can pass the infection to the people who eat their food.

When to Contact a Medical Professional

Call your health care provider if:

• There is blood or pus in your stools
• You have diarrhea and are unable to drink fluids due to nausea or vomiting
• You have a fever above 101°F or your child has a fever above 100.4°F, along with diarrhea
• You have signs of dehydration (thirst, dizziness, light-headedness)
• You have recently traveled to a foreign country and developed diarrhea
• Your diarrhea does not get better in 5 days (2 days for an infant or child), or it gets worse
• Your child has been vomiting for more than 12 hours (in a newborn under 3 months you should call as soon as vomiting or diarrhea begin
• Your child has reduced urine output, sunken eyes, sticky or dry mouth, or no tears when crying

Prevention

Learning how to prevent food poisoning can reduce the risk of this infection.

• Proper food handling and storage can help reduce the risk. Good hand washing when handling eggs, poultry, and other foods is important.
• If you own a reptile, wear gloves when handling the animal or its feces because salmonella can easily pass to humans.

Alternative Names

Salmonellosis; Nontyphoidal salmonella 

References

DuPont HL. Approach to the patient with suspected enteric infection. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 291.

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 142.

Giannella RA. Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010: chap 107.

Update Date: 5/30/2012

Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.