Salmonellosis enteric fever

Particular strains of salmonellae (section 4.2) such as Sal. typhi, Sal. paratyphi and Sal. typhimurium are able not only to penetrate into intestinal epithelial cells and produce exotoxins but also to penetrate beyond into subepithelial tissues. These organisms therefore produce, in addition to the usual symptoms of salmonellosis, a characteristic systemic disease (typhoid and enteric fever). Following recovery frxm such infection the organism is commonly found associated with the gall bladder, hi this state, the recovered person will excrete the organism and form a reservoir for the infection of others. 

Human disease caused by Salmonella generally falls into four categories acute gastroenteritis (enterocolitis), bacteremia, extraintestinal localized infection, and enteric fever (typhoid and paratyphoid fever), and a chronic carrier state. S. typhimurium is the most common cause of salmonellosis. Salmonellosis is a disease primarily of infants, children, and adolescents. 

There is decreasing incidence in rates of salmonellosis in the United States. Foodborne outbreaks of enteric fever are rare, and a small number of cases often are associated with international travel, especially to developing countries. The most common Salmonella serotypes are Typhimurium and Enteritidis, accounting for approximately 50% of isolates from patients. The overall downward trend in rates of salmonellosis is believed to be due to the improved foodhandling practices and water treatment. 

The incubation period is usually 6 8 h after the entry of the organism. The symptoms are nausea, diarrhea, abdominal cramps, fever, myalgia and occasionally headache and vomiting. Stool is loose or watery and does not contain blood. If bloody diarrhea occurs the possibility of Shigellosis or enteric infection with E. coli enterohaemorrhagica should be considered. The majority of cases run a mild or medium severe course which lasts 3 days and symptoms subside completely not requiring hospitalization, unless there is more severe protracted course with fever and bacteremia. Bacteremia is uncommon in non-typhoid Salmonellosis. It has been reported, however, with infection with the serotypes S. choleraesuis, S. typhimurium and S. Heidelberg, which cause recurrent episodes of bacteremia. 

Salmonellosis A common enteritis characterized by abdominal pain, fever, and diarrhea with blood and mucus caused by Salmonella species. 

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