Salmonella (cont.)

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What is the treatment for Salmonella poisoning?

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Treatment for enteritis or food poisoning is controversial. Some doctors recommend no antibiotics since the disease is self-limited, while others suggest using antibiotics such as ciprofloxacin (Cipro, Cipro XR, Proquin XR) for 10-14 days. Some medical investigators believe antibiotics prolong the carrier state.

However, patients with suppressed immune systems (for example, patients with AIDS, undergoing cancer chemotherapy, infants under 2 months of age, or the elderly) should receive antibiotics. They may require hospitalization and be managed by an infectious disease consultant. In addition, pregnancy often predisposes the mother to get all types of food poisoning, including Salmonella. Pregnant females should take care to wash and cook foods well before eating. They should contact their OB/GYN doctor if they begin to have any signs of dehydration, especially if they develop a fever above 101 F.

Supportive therapy for both enteritis and enteric fevers consists mainly of preventing dehydration and electrolyte abnormalities (for example, abnormal levels of potassium and sodium ions) with fluids containing electrolytes (for example, IV fluids or oral fluids like sports drinks).

Carriers of Salmonella are considered to be infected even though they may show no symptoms. Carriers can infect other people and need to be cured of the carrier state. About 85% of carriers can be cured by a combination of surgery to remove their gallbladder and antibiotic treatments.

What are the prognosis (outcome) and complications for Salmonella infections?

The outcomes for Salmonella infections are good in about 80% of people, including promptly treated people with immunosuppression. Patients who develop paratyphoid or typhoid fever usually do well if the diseases are diagnosed and treated early. Patients who become dehydrated, have delayed diagnosis or treatment, or have aggressive or drug-resistant strains of the Salmonella may have a range of outcomes that vary from fair to poor. Untreated patients with typhoid result in about 30% developing severe complications and even death (about 1%-2%). Untreated HIV patients who develop the disease can have a death rate approaching 60%. The severe complications that may develop are as follows:

  • Dehydration
  • Sepsis
  • Intestinal perforation
  • Myocarditis
  • Meningitis
  • Nephritis
  • Hydrocephalus
  • Aortic aneurysm
  • Psychosis
  • Abscesses
  • Carrier state (person has no symptoms but continually sheds contagious Salmonella)

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