The Salmonellosis is a disease due to infection caused by bacteria called Salmonella. The most common infection is at the intestinal level, although there are other clinical presentations, caused by infection in another organ of the body.
The Salmonella is a kind of bacteria which several sub-types are known:
• Salmonella typhi.
• Salmonella paratyphi (A- B- C).
• Salmonella typhimuriun.
• Salmonella enteritidis.
Gastroenteritis due to Salmonella or Salmonellosis is a very common disease, it is known that in the US annually there are more than 1.5 million people infected.
Most of the time with mild gastroenteritis clinical pictures, which can even improve without antibiotic medical treatment and simulate any common intestinal infection.
In other cases it is severe and requires hospitalization and special care.
Causes of Salmonellosis
The way humans acquire Salmonella is established.
• It can be by direct contact with the feces of someone contaminated with Salmonella.
• Through some meals, where Salmonella can survive and multiply for days, weeks, and even months
• Raw food.
• Chicken, fish and seafood meats.
• Uncooked eggs.
• Keeping reptiles and amphibians as pets (turtles), which are important reservoirs for Salmonella.
Risk factor's
There are several risk factors for developing Salmonellosis. Not all individuals who come into contact with the bacteria acquire the disease; they can sometimes serve as carriers or transmission agents of the germ, but without suffering the disease.
Likewise, it must be taken into account that not all individuals who acquire the bacteria and who later develop the infection, have severe symptoms. As mentioned above, many times gastroenteritis due to Salmonella or intestinal Salmonellosis can be mild and resolve spontaneously in a few days without the need for any medical treatment.
In any case, it is very important to identify those types of patients in whom Salmonella infection can turn into a severe or complicated gastrointestinal disease and therefore emphasize preventive measures, or proceed to diagnose and treat this group with special care. susceptible.
These groups of people with the highest risk factor are:
• Children.
• People over 65 years of age.
• Pregnant
• Diabetics
• They are being treated with steroids or immunosuppressants.
• Cancer.
• Patients receiving any type of chemotherapy.
• Patients with pathologies that decrease the body's defenses.
Symptoms of Salmonellosis:
• Diarrhea at first of liquid or mucus consistency. In 20% of cases, blood is reported in the stool, visible or detected by stool tests. Black stools or melena (indicating increased gastrointestinal bleeding) may be seen in 3% of cases.
• Fever.
• Headache.
• Rash on the skin, usually in the initial stages, mainly located on the chest, abdomen, back and neck.
• Sickness.
• Vomiting
• Dizziness
• Joint pain.
• Abdominal pain.
Complications:
There is a long list of complications derived from Salmonellosis, therefore it is always prudent to consult in any case of diarrhea, vomiting or fever that lasts for more than 48 hours in cases of patients without risk factors.
If the patient has risk factors, they should be consulted without delay for any symptoms of gastroenteritis such as those mentioned above. The only guarantee of avoiding complications is early treatment in these cases.
Likewise, it has been shown that in Salmonellosis that persists for many days without treatment, with progressive deterioration of the state of health without treatment or care, mortality can reach 15%.
There is a long list of complications reported in Salmonellosis:
• Intestinal perforation: 3% of cases.
• Neurological
• Meningitis.
• Encephalitis.
• Guillen-Barré syndrome.
• Neuritis.
• Hematological complications.
• Bleeding
• Hepatitis.
• Myocarditis.
• Pneumonia.
• Urinary infections.
Diagnosis:
It is relatively easy to make the diagnosis with blood tests (serologies) and stool tests with cultures to determine the bacteria.
They are complemented by other laboratory tests to identify any additional health problems.
Prevention:
• Frequent hand washing with soap.
• Care in water treatment.
• Avoid consumption of raw food, especially seafood and meat.
• Avoid eating raw eggs.
• Prefer cooked foods.
• Education in restaurants and food outlets.
• Vaccination.
Treatment:
The start of treatment should be as early as possible to reduce the risk of complications. The evolution of symptoms must be monitored after starting treatment, since Salmonella generates a lot of resistance to antibiotics and sometimes it is necessary to modify the initial scheme, while having culture and antibiogram results.
• Hydration and general measures.
• Antibiotics; always having presents the resistance to antibiotics that is frequent in these cases:
• Trimethoprine-sulfamethoxazole.
• Quinolones: ciprofloxacin or norfloxacin.
• Cephalosporin.
• Chloramphenicol.
• Azithromycin.
Asymptomatic carriers should be treated, those people who have the bacteria in their intestines without causing symptoms. They can be detected with stool cultures.
The preferred treatments are based on Trimethoprin-sulfamethoxazole or Ciprofloxacin, administered for 21 to 28 days.
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