Salmonellosis - Causes, Symptoms and Treatments

S. typhi in stools 1 or more years after treatment indicates that the patient is a carrier, while is true of 3% of patients.

Widal's test, an agglutination reaction against somatic and flagellar antigens, may suggest typhoid with a fourfold rise in titer. However, drug use or bepatie disease can also increase these titers and invalidate test results.

Other supportive laboratory values may include transient leukocytosis during the first week of typhoidal salmonellosis, leukopenia during the third week, and leukocytosis in local infection.

Treatment of Salmonellosis:

Antimicrobial therapy for typhoid, paratyphoid, and bacteremia depends on the microbe's sensitivity. it may include amoxicillin, chloramphenicol and, in severely toxemic patients, cotrimoxazole, ciprofloxacin, or ceftriaxone. Localized abscesses may also need surgical drainage.

Enterocolitis requires a short course of antibiotics only if it causes septicemia or prolonged fever. Other treatments include bed rest and replacement of fluids and electrolytes. Camphorated opium tincture, kaolin with pectin, diphenoxylate hydrochloride, codeine, or small doses of morphine may be necessary to relieve diarrhea and control cramps in patients who must remain active.

Special considerations and Prevention tips:

1. Follow standard precautions. Always wash your hands thoroughly before and after any contact with the patient, and advise other hospital personnel to do the same. Teach the patient to use proper hand­washing technique, especially after defecating and before eating or handling food. Wear gloves and a gown when disposing of feces or fecally contaminated objects.

2. Continue standard precautions until three consecutive stool cultures are negative­the first one 48 hours after antibiotic treatment ends, followed by two more at 24­hour intervals.
3.Observe the patient closely for indications of bowel perforation: sudden pain in the lower right abdomen, possibly after one or more rectal bleeding episodes; sudden fall in temperature or blood pressure; and rising pulse rate.

4. During acute infection, allow the patient as much rest as possible. Raise the side rails and use other safety measures because the patient may become delirious.

5. The patient should have a room close to the nurses' station so he can be checked on often. Use a room deodorizer (preferably electric) to minimize odor from diarrhea and to provide a comfortable atmosphere for rest.

6. Accurately record intake and output. Maintain adequate I.V. hydration. When the patient can tolerate oral feedings, encourage high-calorie fluids such as milk shakes. Watch for constipation.

7. Provide good skin and mouth care. Turn the patient frequently, and perform mild passive exercises as indicated. Apply mild heat to the abdomen to relieve cramps.

8. Don't administer antipyretics. These mask fever and lead to possible hypothermia. Instead, to promote heat loss through the skin without causing shivering (which keeps fever high by vasoconstriction), apply tepid, wet towels (don't use alcohol or ice) to the patient's groin and axillae. To promote heat loss by vasodilation of peripheral blood vessels, use additional wet towels on the arms and legs, wiping with long, vigorous strokes.

9. After draining the abscesses of a joint, provide heat, elevation, and passive range­of-motion exercises to decrease swelling and maintain mobility.

10. If the patient has positive stool cultures on discharge, tell him to use a different bathroom than other family members if possible (while he's on antibiotics); to wash his hands afterwards; and to avoid preparing uncooked foods, such as salads, for family members.

11. To prevent salmonellosis, advise prompt refrigeration of meat and cooked foods (avoid keeping them at room kill perature for any prolonged period), and teach the importance of proper hand washing. Advise those at high risk of contracting typhoid (laboratory workers, travelers) to seek vaccination.