Infectious diseases. Salmonella (most important)

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Infectious diseases. Salmonella (most important)

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2. Salmonella

Salmonellosis is an acute infectious disease of humans and animals caused by Salmonella serovars and occurring in children more often in the form of gastrointestinal, less often typhoid-like and septic forms.

Etiology. Salmonella are motile Gram-negative bacteria that do not have a capsule and do not form spores. The main antigens of Salmonella are flagellar (H), cell wall antigens (O) and thermolabile envelope antigens (Vi), blocking the agglutination reactions of O-antigens and O-antibodies. There are more than 2200 serotypes of Salmonella.

Salmonella are resistant to many physical factors, they die at a temperature of 54,4 ° C after 1 hour, and at 60 ° C - after 15 minutes.

Epidemiology. Human infection occurs through the consumption of contaminated food or water. The main carrier of Salmonella is a person, often serving as a source of food contamination and poisoning.

Salmonella indirectly stimulates the energy system of intestinal epithelial cells, resulting in increased secretion of water and electrolytes.

Clinical manifestations. The incubation period is 8-48 hours. The onset is acute, accompanied by nausea, vomiting, cramping pains in the abdomen, after which a large amount of feces of a liquid consistency, sometimes mixed with mucus and blood, leaves. Vomiting is usually profuse and short-lived. Body temperature rises to 38-39 ° C in 70% of patients.

Infection in some individuals proceeds without fever with minor bowel dysfunction. In other patients, the body temperature rises sharply, headaches appear, consciousness is disturbed, convulsions and meningeal phenomena develop. Sometimes there is a strong bloating, muscle tension, significant local pain.

Hematogenous dissemination of Salmonella is accompanied by chills and fever. It usually occurs in children under 3 months of age. Salmonella can settle in any organ, causing pneumonia, abscesses, empyema, osteomyelitis, purulent arthritis, pyelonephritis, or meningitis.

Complications. Children have reactive arthritis, which develops 2 weeks after the onset of diarrhea, Reiter's disease.

The diagnosis is made on the basis of the results of bacteriological studies, when the material is incubated on a medium enriched with tetrathionate, followed by transfer to a selective medium.

Treatment. Treatment should be aimed at correcting electrolyte disturbances and maintaining adequate hydration. Treatment with antibiotics is indicated only in some cases: when there is a danger of spreading the infection.

With septicemia, high body temperature and metastatic foci of infection, children should be treated with ampicillin, amoxicillin or levomycetin, one of which is prescribed in 4 doses with an interval of 6 hours.

Author: Pavlova N.V.

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