Salmonella enterocolitis

Definition

Salmonella enterocolitis is an infection in the lining of the small intestine caused by the bacteria Salmonella.

Alternative Names

Causes

Salmonella enterocolitis is one of the most common types of food poisoning. It occurs when you swallow food or water that is contaminated with the salmonella bacteria. Any food can become contaminated during preparation if conditions and equipment for food preparation are unsanitary.

The time between infection and symptom development is 8 to 48 hours. The acute illness lasts for 1 to 2 weeks. The bacteria is shed in the feces for months in some treated patients. A carrier state exists in some people who shed the bacteria for 1 year or more following the initial infection.

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

• Eaten improperly prepared or stored food (especially undercooked turkey or chicken, unrefrigerated turkey dressing, undercooked eggs)
• Family members with recent salmonella infection
• Had a recent family illness with gastroenteritis
• Been in an institution
• Eaten chicken recently
• A pet iguana or other lizards, turtles, or snakes (reptiles are carriers of salmonella)
• A weakened immune system

Approximately 40,000 people develop salmonella infection in the United States each year. Most patients are younger than 20. The highest rate occurs from July through October.

Symptoms

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

Exams and Tests

The doctor 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:

• Stool culture for salmonella
• Febrile/cold agglutinins (test for specific antibodies)

Treatment

The goal of treatment is to replace fluids and electrolytes (salt and minerals) lost by diarrhea. Antidiarrheal medications are generally not given because they may prolong the infection. If you have severe symptoms, your doctor may prescribe antibiotics.

You should drink electrolyte solutions to replace fluids lost by diarrhea -- these are available without a prescription.

Persons with diarrhea who are can't drink anything by mouth due to nausea may need medical attention and intravenous fluids. This is especially true for small children. Fever and aches can be treated with acetaminophen or ibuprofen.

If you take diuretics, you may need to stop taking them during the acute episode, when diarrhea is present. Ask your health care provider for instructions.

Changing your diet during diarrhea may help reduce symptoms. This may include avoiding milk products and following a BRAT diet. BRAT stands for bananas, rice, applesauce, and toast. These are binding foods that make the stools harder

Infants should continue to breastfeed and receive electrolyte replacement solutions as directed by your health care provider.

Outlook (Prognosis)

The probable outcome is usually good. Symptoms subside in normal individuals in 2-5 days.

Possible Complications

Dehydration from diarrhea, especially in young children and infants, is a dangerous complication. Life-threatening meningitis and septicemia may also result. Food handlers who develop the carrier state can pass the infection along to the people who eat their food.

When to Contact a Medical Professional

Call your health care provider if blood is noted in the stools, or if there is no improvement after 2-3 days. Also call if any of the following occurs:

• Vomiting or abdominal pain is severe
• Signs of dehydration are present: decreased urine output, sunken eyes, sticky or dry mouth, absent tears when crying
• Unresponsiveness

Prevention

Proper food handling and storage are preventive measures. Good hand washing is important especially when handling eggs and poultry.

If you own a reptile, wear gloves when handling the animal or its feces because Salmonella is easily passed from the animal.