How is salmonellosis treated. Salmonellosis is an acute infectious disease caused by bacteria of the genus

salmonellosis is an infectious disease that is caused by various types of bacteria of the genus Salmonella, with more than 2200 serotypes. As a rule, salmonellosis is accompanied by damage to the organs of the gastrointestinal tract.

Sources of infection are domestic birds and animals, as well as a person sick with salmonellosis. Infection with salmonellosis is caused by eating foods containing a large number of salmonella, which occurs when they are insufficiently cooked. The incubation period in the food way of infection is 6-72 hours. With contact-household transmission of the infection, the incubation period increases to 3-8 days.

Symptoms of salmonellosis

The main clinical forms of salmonellosis:

gastrointestinal;
generalized;
acute, chronic and transient bacteriocarrier;
subclinical form.

Symptoms of the gastrointestinal form of salmonellosis

The most common form of salmonellosis is gastrointestinal, characterized by the following symptoms:

acute onset of the disease
fever,
chills,
weakness,
stomach ache,
headache,
nausea,
vomit,
stool disorder.

Some patients first develop fever and signs of poisoning, and then develop symptoms associated with gastrointestinal dysfunction. The duration and severity of symptoms of salmonellosis depend on the severity of the disease.

The mild form of salmonellosis is characterized by a single vomiting, a prolonged increase in body temperature up to 37-37.5 degrees, loose watery stools several times a day, lasting 1-3 days, fluid loss up to 3% of body weight.

With a moderate form of salmonellosis, symptoms such as:

temperature rise to 38-39 degrees, up to 4 days;
repeated vomiting;
loose stools several times a day, up to a week;
tachycardia;
pressure reduction;
dehydration of 1-2 degrees is possible, with loss of fluid up to 6% of body weight.

The severe course of the gastrointestinal form is accompanied by the following symptoms of salmonellosis:

In addition, there is an increase in the spleen and liver, tachycardia, cyanosis of the skin, a significant decrease in pressure. On the part of the kidneys, albuminuria, oliguria, casts and erythrocytes in the urine, an increase in residual nitrogen are possible.

Perhaps the development of acute renal failure. Dehydration of 2-3 degrees, manifested in cyanosis, dry skin, convulsions and aphonia. Fluid loss by the body reaches 7-10% of body weight.

Symptoms of a generalized form of salmonellosis

The typhoid subtype of the generalized form of salmonellosis begins acutely. The first symptoms of salmonellosis are intestinal disorders, combined with general intoxication and high body temperature. After 1-2 days, intestinal dysfunction stops, the body temperature continues to be high, and the symptoms of intoxication become more intense.

Fever can be undulating or constant. Patients show lethargy, lethargy and pallor, some have a herpetic rash on the 2nd or 3rd day, and a roseolous rash on the abdomen from the 6th or 7th day.

In addition, relative bradycardia, decreased blood pressure, and muffled heart sounds may occur. Dispersed dry rales are heard. By the end of the 1st week of the course of the disease, an increase in the liver and spleen occurs. High body temperature lasts 1-3 weeks.

The most severe variant of the generalized form of salmonellosis - the septic form of the disease begins acutely and has a typhoid-like course in the first days. Then the condition of the patients worsens - there are significant fluctuations in body temperature, with chills and sweating.

The clinical symptoms of this variant of salmonellosis are diverse, and its diagnosis is difficult. Often, purulent foci are formed in the musculoskeletal system.

From time to time there is septic endocarditis, aortitis with the formation of aortic aneurysm, tonsillitis, cholecysto-cholangitis, meningitis, purulent cervical lymphadenitis. Less common: infection of an ovarian cyst, liver abscess, mastoiditis, salmonella strumitis, abscess of the gluteal region.

Which doctors to contact with salmonellosis

Treatment of salmonellosis

Mild forms of salmonellosis do not require treatment and patients do not seek medical attention. In severe forms, gastric lavage should be done with warm water or a solution of baking soda. After washing, a laxative is used.

In case of intoxication, intravenous or subcutaneous injections of 1000-1500 ml of saline in half with 5% glucose solution are used. If vomiting does not stop, hypertonic sodium chloride solution is injected intravenously.

If necessary, prescribe cardiovascular agents. In a state of collapse, Polosukhin's anti-shock liquid is injected intravenously. In severe collapse, 500-1000 ml of polyglucin is administered intravenously.

To relieve intoxication in severe forms of salmonellosis, it is recommended to administer hemodez intravenously or drip. With chills and cramps, warm baths and heating pads are prescribed for the legs. In septic and typhoid forms, after vomiting stops, antibiotic treatment is used.

Drugs for salmonellosis

Diet after salmonellosis treatment

Nutrition after treatment for salmonellosis is practically the same as usual, with the exception that about salmonellosis treatment at home for a week, berries, raw fruits and vegetables, and sour-milk products should not be included in the diet. To restore the intestinal microflora, it is more advisable to take probiotics, rather than dairy products, which can cause flatulence and upset stools.

Pickles are also best avoided as they can lead to fermentation. During the rehabilitation period, it is advisable not to overload the gastrointestinal tract with heavy fatty and spicy foods. Light soups, crackers and bagels, mashed potatoes, boiled meat are shown - this is the most “safe” food for a recovering gastrointestinal tract.

Prevention of salmonellosis

Prevention of salmonellosis consists in the following measures:

sanitary and veterinary supervision of livestock slaughter;
proper storage and transportation of meat;
food storage at low temperature;
reliable heat treatment of products;
separate processing of raw and cooked products;
isolation of patients and carriers of salmonella;
compliance with the rules of personal hygiene.

Salmonellosis in children

Symptoms of salmonellosis in children

As a rule, in children older than 3 years, a gastrointestinal form of salmonellosis occurs, the course of which occurs according to the type of food poisoning, and the duration of the incubation period ranges from several hours to 2-3 days.

The disease may be characterized by signs of gastroenteritis, gastritis or gastroenterocolitis. Salmonellosis in children older than 3 years is characterized by an acute onset of the disease and the occurrence of such symptoms as:

nausea and vomiting,
increase in body temperature up to 38-39 ° C,
lack of appetite,
stomach ache.

After a few hours, loose, watery and copious stools appear, sometimes mixed with blood and mucus. The frequency of diarrhea depends on the severity of salmonellosis. Then dehydration and severe toxicosis begin, convulsions are possible.

In young children, the contact-household route of infection predominates, but they also have the most common forms of the disease - gastroenterocolitis and gastroenteritis. Salmonellosis begins less acutely, with the maximum manifestation of all signs after 3-7 days.

Symptoms of salmonellosis in young children:

heat,
lethargy,
pallor,
slight cyanosis of the nasolabial triangle.

Vomiting may begin immediately, but may appear later, sometimes is persistent. Dehydration develops. The stool in children is liquid, fecal in nature, gradually acquires a dark green color, with an admixture of mucus, sometimes blood, of a large volume.

In infants, salmonellosis manifests itself in moderate and severe forms, in addition to dehydration and intoxication, complications resulting from the ingress of salmonella into the blood are possible. In children with immunodeficiencies, there is a tendency to a protracted course of the disease with prolonged bacterial excretion.

First aid for salmonellosis in children

The first aid in case of food infection of children with salmonellosis is gastric lavage, which should remove a certain amount of bacteria and toxins from the child's body in order to alleviate the condition and remove intoxication.

For washing use 2% sodium bicarbonate solution or warm water. With a mild course of the disease without dehydration, gastric lavage can return the child to a normal state.

At home, gastric lavage can only be done for children over 3 years old: the child drinks a glass of liquid, after which he is pressed on the root of the tongue with a finger, causing vomiting. The procedure is repeated until the wash water is completely clean.

Diet for salmonellosis in children

The diet for salmonellosis in children should be extremely sparing of the intestines, therefore only boiled and pureed dishes and foods are used (diet No. 4). Whole milk and fats of animal origin are excluded from the diet, except for butter, vegetables rich in fiber.

Doctors advise giving the child rice and oatmeal porridge with water and vegetable broth, meatballs, steam cutlets, boiled fish, fruit jelly, mild cheeses, and cottage cheese.

The diet for salmonellosis is diversified gradually, and the usual diet is switched to with a complete clinical recovery, as a rule, 28-30 days after the onset of the disease.

Treatment of salmonellosis in children

Treatment of children with salmonellosis is individual and is prescribed by a pediatric infectious disease specialist. Most Salmonella species are resistant to antibiotics, so they are not usually used in treatment. The main emphasis is on diet, correction of dehydration and elimination of toxins.

With the development of common forms of salmonellosis, the treatment of children should take place in a hospital. In these cases, the use of antibiotics is mandatory, for which it is necessary to determine the susceptibility of Salmonella to antibiotics and choose the most effective of them.

The initial drugs of choice are chloramphenicol and ampicillin in age dosages. With prolonged bacteriocarrier, the main thing in the treatment of salmonellosis in children is the use of drugs to increase immunity.

Bacteriophages are used - drugs that destroy salmonella. To restore the intestinal microflora, bifidumbacterin and bifikol are used, as well as sour-milk products with bifidobacteria.

Questions and answers on the topic "Salmonellosis"

Question:Hello, a 9-year-old child was treated with salmanulosis in the hospital, was discharged with diarrhea. The diarrhea continues to this day. How to stop it? Already 5 days at home

Answer: The child needs to be seen by a doctor.

Question:Pain in the leg after salmonellosis, what to do?

Answer: One of the consequences of the disease is arthritis, which causes pain in the joints.

Question:Good afternoon! The 3rd day is tormented by diarrhea and bloating. On the first day there was a temperature of 38.7 - we managed to bring it down. Now I feel fine in general, but the diarrhea does not go away. The stool is not green and seems to be without visible mucus. The attending physician eyeballed the diagnosis of salmonellosis and called an ambulance for my hospitalization, which I refused. Hope to get back on my own. I drink intetrix, bactisubtil, imodium, arbidol and mezim forte. Dear doctors, please tell me, will I live? Or listen to the doctor and run to the infectious diseases hospital? - I really don't want to.

Answer: Self-medication is always dangerous, but you will live. I think you will be all right. The survey won't turn up anything. If it doesn't go away, you need to see an infectious disease specialist. Continue treatment for 5 days. Further, only bactisubtil and dite (without black bread, legumes and whole milk). Wash fruits and vegetables thoroughly and heat-treat.

Question:My girlfriend (24 years old) has a son (1 year 8 months). At the end of September, the whole family was ill with salmonellosis, a friend and her son were in the hospital. The child had to be weaned there (literally in 3 days). A friend was treated with Norbaktin, took him after discharge, from 2 to 7 October. Around this time, conception occurred! A friend is determined to have an abortion, because she is afraid that salmonella and norbactin could adversely affect the fetus. In general, she wants a child, and I really want to help her collect as much information as possible about what are the chances of giving birth to a child without pathology in this situation. Thank you.

Answer: Past salmonellosis and taking norbactin during the expected period of conception is not an indication for termination of pregnancy. Pregnancy should proceed normally.

Question:Good afternoon! She gave birth to a child at 36-37 weeks. I was discharged, and the child was transferred to the hospital. There are children without their mothers. They were allowed to come, breastfeed, but it was necessary to pass an analysis for the intestinal group. On Monday I passed the test, and on Friday they said that they found salmonellosis in me. Weaned from the child, not allowed to bring expressed milk. On the same day I passed this analysis again in three different places. I went to the therapist, she prescribed to drink chloramphenicol 0.25 three times a day. I have no symptoms, the stool is normal. They said I could be a carrier. Tell me, could I infect a child? How many days after the last dose of chloramphenicol can I breastfeed?

Answer: You need to be patient and treat yourself and express milk regularly to keep milk production in your breasts. Of course, you could infect a child with salmonella. Therefore, everyone is recommended before conception and after a good examination of the body and, if necessary, treat the mother in advance. A healthy mother is a healthy baby. After the end of antibiotics, it is excreted from the body for another 8 hours. After 10 hours, it will not be in milk. If the infection is not treated, there may be an infection in the milk. Therefore, do not rush. But communicate with your child regularly.

Question:My child was diagnosed with salmonellosis (child 6 years old). A week before the results were ready, we were diagnosed with a rotavirus infection. The child had a temperature of 38-39 for 3 days, vomiting on the very first day of illness, loose stools. We drank smecta, arbidol and lineks. A week later, we went to the reception and they told us that the rotovirus infection was not confirmed, and that we had salmonellosis. But the child is doing well. There is an appetite, not lethargic. I asked the doctors to take a second stool test before starting to give the child antibiotics, but they assured me that there could be no mistake, and that we had 100% salmonellosis. Is it so that there is no mistake, and if the analysis is confirmed, then treatment should be started? But why then are there no signs of this disease at the moment?

Answer: If the doctors are confident in the correctness of the analysis, then you should not doubt it. Salmonellosis in older children often occurs in a mild form, without obvious symptoms. Be sure to listen to the opinion of doctors and go through the prescribed treatment.

Question:Please tell me: a child (9 years old) had salmonellosis. 2 weeks later SARS happened. I understand that while they were chasing salmonella, they weakened the intestinal flora. What should we do first? Restore intestinal flora? Or act differently?

The first measure really should be the restoration of the intestinal microflora. Then it will be possible to conduct a course of treatment with immunostimulating drugs.

Question:Hello! Does my daughter, she is 5.5 months old, have bloody stools? What does this mean? And how to treat? There was a temperature for 3 days, 38 and 2, the temperature was brought down. Thanks in advance.

Answer: Diarrhea with an admixture of blood is most often a sign of an intestinal infection (even salmonellosis is possible). We recommend that you take your child to the doctor as soon as possible.

Question:A 5-year-old child was diagnosed with salmonellosis. How many days do you need to take an antibiotic to fully recover? Is 7 days enough? And when can I take a control analysis?

Answer: It is usually recommended to continue a weekly course of antibiotic treatment for salmonellosis for up to 10 days. Fecal analysis should be taken immediately after the end of treatment, and then again after a few weeks.

Question:If a family member has been ill with salmonellosis - how long can he remain a carrier of the infection and what precautions should be taken?

Answer: Carrying and isolating a Salmonella infection can last from several weeks to several months. In order to reduce the risk of infection of others, the patient must undergo adequate treatment (antibiotics + enterosorbents + probiotics) under the supervision of a specialist and, after the end of treatment, pass stool tests.

Salmonellosis is the most dangerous disease, which, with a negative prognosis, can provoke a comic state. Every person, without exception, can become infected with this disease, and pass the infection on to their loved ones, even to infants. Today, information about and treatment of salmonellosis is very relevant, due to the increase in the number of infections worldwide, so everyone should know what measures to take if the first symptoms appear.

What is salmonellosis

- an infectious disease caused by bacteria - salmonella, that have entered the human body. This infection is registered in any corner of the world, and if no measures are taken, an outbreak of salmonellosis may occur.

You can become infected with salmonellosis by drinking dirty, untreated water and nutrients contaminated with this type of pathogen. Most often, they attack the digestive system, because the bacteria initially get there, through the oral cavity, after which they develop and multiply there.

These products include: poultry eggs and meat, milk, butter, etc. Children less than 1 year old are most often infected. Their symptoms are expressed in a change in the type of calla, an increase in temperature is possible. Then it turns out that against the background of low immunity, the child received infection from an infected mother (through breast milk), and the mother herself could become infected, for example, by drinking a raw chicken egg.

When eating salmonella-contaminated food, it is impossible to determine whether it is infected or not, using visual inspection, odor detection, and even the taste of food with an infection is no different from uninfected dishes. Therefore, you can protect yourself from infection by excluding raw chicken and dairy products from your diet.

It is worth being wary of the warm season. Then scientists record outbreaks of salmonellosis, which, despite the long struggle of doctors with infection, end in fatal consequences.

The person himself can also become a source of infection. During emptying, bacteria are released that can get on the skin of the hands and be transmitted through contact to a healthy person.

Symptoms and treatment

4 days after the penetration of Salmonella into the body, the incubation period of the disease ends, and minor symptoms begin to appear, regardless of the age category of the patient. These signs are completely insignificant, therefore, do not arouse suspicion, requiring immediate medical attention. Therefore, the infection has the opportunity to develop and spread, causing unexpected consequences.

The very first signs of a disease that resemble food poisoning begin to appear:

Cutting pain in the abdomen.
Feeling bloated and gassy.
Diarrhea with an unpleasant odor, possibly the presence of mucous or blood impurities in the stools.
Constant vomiting.
Fluid deficiency in the body caused by vomiting and diarrhea.
Reluctance to eat.
Body temperature over 38 C.
Muscle and bone aches.
Deviations of a neurological nature: dizziness, migraine, poor sleep.

The sudden appearance of such symptoms in one of the family members requires absolute isolation from others in order to avoid transmission of infection. You should also immediately call a doctor and undergo the necessary examination.

Having found the Salmonella bacterium in the body, specialists will offer urgent hospitalization, which should not be abandoned. This is due to dehydration, which provokes an infection. Consequently, from the loss of fluid required for the full functioning of the body, a person can fall into a prolonged coma. It is required to be especially vigilant for women during pregnancy, and for people who have reached the senile state.

Symptoms of childhood salmonellosis

In children, the signs of salmonellosis are the same as in adults. Therapeutic treatment of the disease largely depends on the amount of fluid in the body. In children infected with salmonellosis up to a year, a critical lack of fluid can occur in a couple of hours, and cause additional symptoms:

Dry mouth.
Lack of tear production.
The skin of the sick child is pale, and the hands and feet are cold.
General health is weak, so the child sleeps a lot.

How to treat salmonellosis

The main point for getting rid of salmonella is drinking plenty of fluids, because the lack of fluid in salmonellosis is a serious complication. With dehydration, a person’s water-electrolyte balance is disturbed, then doctors purposefully throw all their efforts into its restoration, using the following drinking complex:

Weakly concentrated tea without sugar (black or green at the patient's choice).
Mineral water.
Salt solution.

A feature of the use of these liquids is that they need to be taken in small sips or 1⁄2 or 1 tsp. (children), for 1-3 days, depending on the doctor's prescription.

How to treat intestinal salmonellosis

The second main point in intestinal infection is a special diet and its exact observance. It allows you to restore the working functionality of the digestive tract, therefore, before absolute recovery from the patient's diet, products that irritate the digestive organs should be eliminated.

A patient with salmonella is prohibited from the following products:

Raw foods of any origin (with an infection in the intestines, you can only eat baked, boiled or stewed fruits / vegetables).
Bakery products are absolutely contraindicated.
Whole milk.
Any sausages and semi-finished products.
Animal fats.
Alcoholic, carbonated, coffee drinks.
Sweet, fried, fatty.
Mushrooms.
Seafood.

Medical treatment of salmonella in adults

Getting rid of salmonella largely depends on drug treatment that destroys bacteria. In this case, the patient must be in hospital, under the supervision of a physician. Treatment with the help of pharmaceutical preparations is carried out for 7-10 days, but in especially severe forms of the disease, the medication lasts longer.

To help the body cope with diarrhea that provokes dehydration, doctors prescribe Loperamide. However, the manufacturer of the drug does not recommend using it for longer than 5 days.

Antibiotics are prescribed to patients who are in serious condition. These drugs are administered intravenously, and when a favorable prognosis for the course of the disease is obvious, they are injected intravenously or offered to drink in tablet form. Most often, specialists prescribe the following antibiotics:

"Azithromycin".
"Cefotaxime".
"Ciprofloxacin".

After taking antibiotics, the next stage of treatment begins -. For this, various measures are taken, but the enema is considered the most important, fast and highly effective.

If the patient has severe pain in the head, accompanied by fever, Paracetamol and Ibuprofen are used to eliminate these unpleasant sensations.

The next stage of treatment begins the restoration of the working capacity of the digestive tract. Enzyme-containing agents are used here, for example: Creon, Festal, Mezim. Given that antibiotics affect the functionality of the gastrointestinal system, you should additionally drink a full course of probiotics, focused on its restoration, and containing live beneficial bacteria: Acipol, Lactobacterin, Bifidumbacterin.

Features of the treatment of salmonellosis in children

Specific means for the treatment of children from salmonellosis have not been developed, so this should be done by a doctor (in stationary conditions). He will use drugs intended for adults, and in order not to harm the baby, he will specifically select the dosage, based on the weight and age of the child.

Also, the attending physician will prescribe a plentiful drink, elimination of toxins and a diet, but the baby will need it even at the end of treatment. This is due to the effect of antibiotics on the children's body, as a result of which, a load on the digestive organs will be created.

Traditional medicine against salmonellosis

The use of folk methods against salmonellosis does not give a 100% guarantee of recovery, but it will serve as a good way to speed up recovery. The use of these recipes is not harmful, but in order to avoid trouble, it is recommended to consult a specialist.

Plantain tincture- one of the effective homemade medicines. Requires 1 tbsp. l. crushed plantain pour 1 tbsp. boiling water. The medicine is infused for 15 minutes and drunk in small sips, for 1-2 hours.
Peeled walnuts also a good way to get rid of infection in the intestines. It takes 1 cup of nuts to pour 2 liters of alcohol or moonshine. Insist in a dark place for 5 days. For the treatment of children, every 2 hours, dilute 5 drops of tincture in purified water, and then give it a drink. For adults, the treatment algorithm is the same, but the dosage is doubled.
Camomile tea improves the functionality of the immune system. To prepare the infusion, pour 1 tbsp. l. herbs 1 cup boiling water and simmer for about 5 minutes. You can use it after 2 hours. Adults should drink tincture at least 4 times a day, 2 tablespoons (after meals).
Peppermint essential oil is an excellent pain reliever for the abdomen. To use it, you should put a few drops on the skin (sore area of the body) and rub in gentle, circular motions.

Timely detection of salmonellosis is very important for every person, because neglect of the first signs can cause a deterioration in the patient's condition and complications that will not disappear after recovery. That is, untimely treatment will lead to kidney and heart failure, provoke a chronic increase in blood pressure, and in the worst case, lead to a coma.

Salmonellosis is an infectious intestinal disease caused by pathogens of the genus Salmonella. The main source of infection is animals (agricultural, rodents), less often people. Infection in the human body is possible with contaminated food and water. A contact-household route of infection is also possible.

Salmonella, caught in the small intestine, are introduced into its mucous membrane. Their vital activity is accompanied by the release of toxins, which causes pain and intoxication syndromes and the occurrence of diarrhea.

Salmonellosis symptoms

Chicken eggs are often the source of salmonellosis infection.

The incubation period lasts an average of 12–24 hours; with the contact-household method of infection, it is possible to lengthen the incubation period up to 8 days.

There are several clinical forms of salmonellosis:

gastrointestinal (localized);
generalized form, proceeding in the form of septic and typhoid-like variants;
bacteriocarrier;
subclinical form.

Gastrointestinal form

The most common form of the disease. It begins acutely with an increase in body temperature up to 39 C, the appearance of weakness, chills and headaches. Patients complain of pain in the epigastric region, accompanied by nausea and repeated vomiting. A little later, diarrhea joins.

The severity of symptoms depends on the severity of salmonellosis. With a mild form of the disease, the intoxication syndrome can be mildly expressed, vomiting is single, loose stools up to 5 times a day. The moderate form is characterized by an increase in body temperature up to 38-39 C, repeated vomiting, watery stools up to 10 times a day. Since there is a significant loss of fluid for the body, patients experience tachycardia and a decrease in blood pressure, and if left untreated, dehydration may develop. In a severe form of the disease, intoxication of the body is pronounced, repeated vomiting, stools more than 10 times a day, watery, fetid with an admixture of mucus. Patients have an enlarged spleen and liver, and jaundice may occur. As a result of the loss of a significant amount of fluid, the body develops a violation of water-salt metabolism and dehydration. Against this background, tachycardia occurs, a pronounced decrease in blood pressure, impaired function of the urinary and nervous systems.

Typhoid-like variant of the course of the disease with a generalized form

The first symptoms of the disease may be intestinal disorders against the background of general intoxication of the body. After 1-2 days, the intestinal manifestations of salmonellosis disappear, and the intoxication syndrome increases. Fever is most often undulating (alternating periods of high temperature with periods of normal body temperature). In most patients, on the 2nd–3rd day from the onset of the disease, an appearance is possible, and from the 6th–7th day, a roseolous rash appears, localized mainly on the skin of the abdomen. The abdomen is swollen, at the end of the first week of the disease, the liver and spleen increase. Intoxication syndrome can last up to 3 weeks.

Septic variant of the course of the disease in a generalized form

This form of the disease is the most severe. The disease has an acute onset and imitates a typhoid-like course in the first days, but the condition of patients deteriorates sharply. Fever occurs with large daily swings, chills and intense sweating.

This form of the disease is difficult to treat with antibiotics, and secondary septic foci occur, which can make it difficult to diagnose salmonellosis. Purulent foci often form in the musculoskeletal system, tonsillitis, meningitis, and lymphadenitis occur.

Bacteriocarrier

With this form of the disease, its clinical manifestations are absent, but pathogens are detected in the biological material in laboratory studies.

Acute carriage is said to occur if the excretion of the pathogen lasts from 2 weeks to 3 months. Chronic bacteriocarrier is characterized by the release of the pathogen for more than 3 months. For transient bacterial excretion, the absence of clinical manifestations is characteristic, but pathogens were detected in the material 1-2 times during bacteriological studies (the interval between studies should be one day). In this case, the results of serological studies should be negative.

subclinical form

With this form of salmonellosis, there are also no clinical manifestations of the disease, but the results of bacteriological studies of feces and serological reactions will be positive.

Diagnostics

The diagnosis is made on the basis of clinical data and epidemiological history.
The main diagnostic method is bacteriological. For the study, vomit, feces, urine and blood of patients are needed, and in septic forms and cerebrospinal fluid.

An additional diagnostic method is sigmoidoscopy, which is performed to assess the condition of the intestinal mucosa. Patients also undergo blood and urine tests.

Treatment

Infusion therapy will help correct violations of water-salt metabolism resulting from vomiting and diarrhea.

Treatment of salmonellosis should be carried out in an infectious diseases hospital. Patients need bed rest and, excluding foods that irritate the stomach, increase peristalsis and fermentation processes.

Treatment of the disease is complex:

Antibacterial therapy aimed at the destruction of the causative agent of the disease.
Correction of violations of water-salt metabolism with solutions of rehydron, trisol.
Reducing the manifestations of intoxication syndrome by introducing solutions of glucose and rheopolyglucin.
Removal of toxins directly from the intestinal lumen using sorbents (Smecta, Enterosgel).
Treatment (Imodium).
Restoration of digestive function with the help of enzyme preparations (Mezim, Creon).
To restore the intestinal microflora, eubiotics are prescribed (Bifidumbacterin, Linex).

More information about the treatment and, very importantly, the prevention of salmonellosis infection,.

It should be remembered that salmonellosis is a deadly disease, therefore, at the first signs of the disease, you should consult a doctor. Self-medication in this case is unacceptable and may lead to a decrease in the effectiveness of further treatment prescribed by a doctor.

Which doctor to contact

If you suspect an acute intestinal infection, including salmonellosis, it is necessary to call an ambulance, which will take the sick person to the infectious diseases department. Self-medication in this case is dangerous not only for health, but also for life. After discharge from the hospital, during the rehabilitation period, it is useful to consult a gastroenterologist and nutritionist on proper nutrition in order to restore digestive function as soon as possible.

Salmonellosis is an infectious disease caused by various types of bacteria of the Salmonella genus. Salmonellosis is characterized by a variety of clinical manifestations and can have both asymptomatic and severe septic forms. In most cases, salmonellosis in children and adults leads to damage to the digestive tract, which is often complicated by toxic and dehydration shock.

More than 2,000 Salmonella serotypes are currently known to researchers. The main sources of salmonellosis are poultry and animals, however, humans can also act as a carrier. Most often, salmonellosis, the symptoms of which appear after eating contaminated food, develops as a result of improper culinary processing of food. In a special risk group are: meat of mammals and birds, fish, eggs, milk, cottage cheese, sour cream. Salmonellosis can also be contracted by drinking poor-quality water from open reservoirs or city water supply.

When ingested, Salmonella quickly overcome the protective barriers of the stomach and penetrate into the mucous membrane of the small intestine. At the same time, their activity is accompanied by an intensive release of toxins, which cause the main signs of salmonellosis.

Symptoms of salmonellosis, forms and clinical picture of the disease

The incubation period of infection ranges from several hours to 2-3 days. It is possible to develop nosocomial outbreaks when the disease is transmitted by household means. In this case, the symptoms of salmonellosis usually appear after 3-8 days. Briefly consider the main clinical forms of salmonellosis.

Gastrointestinal form- is the most common and is diagnosed in 96-98% of patients applying to medical institutions with suspected salmonellosis. The consequences of this type of infection depend on the severity of the disease and the severity of the clinical symptoms of salmonellosis, which include:

general weakness;
headache;
an increase in body temperature up to 40 degrees and above;
nausea, vomiting;
pain in the umbilical region;
stool disorders.

Symptoms of salmonellosis, indicating changes in the gastrointestinal tract, appear after 2-3 days from the onset of the disease. In the first days the patient feels only a slight intoxication and fever. With a mild form of salmonellosis, the symptoms are rather mild, and the patient practically does not feel the unpleasant consequences of the infection. A completely different picture is observed in cases where severe gastrointestinal salmonellosis develops, the treatment of which is carried out only in a hospital. With this form of salmonellosis, patients suffer from:

high fever and fever lasting more than 5 days;
severe intoxication;
fetid, watery stools (10 times a day or more), sometimes with an admixture of mucus;
skin cyanosis;
a significant drop in blood pressure;
tachycardia;
enlargement of the liver and spleen;
changes in the kidneys (albuminuria, oliguria, high nitrogen content;
acute renal failure.

If left untreated, salmonellosis in children and adults leads to significant disturbances in water-salt metabolism, dehydration of II-III degree. In this condition, patients experience convulsions, dry skin, cyanosis, and aphonia. Often, fluid loss reaches 10-12% of body weight, which causes numerous disturbances in the work of the main body systems. The most common clinical variant of the gastrointestinal form is gastroenteric salmonellosis, the consequences of which are manifested in the form of destructive changes in the colon and colitis.

Typhoid form of salmonellosis- begins acutely, manifested by intestinal disorders already in the first days after the onset of the disease, however, after a few days, intestinal dysfunctions disappear. However, the patient's temperature remains consistently high. Also, patients are observed: apathy, lethargy, pallor of the skin, herpetic and roseolous rash. In some cases, typhoid-like salmonellosis leads to bradycardia, lowering blood pressure, muffled heart sounds. Signs of salmonellosis, indicating damage to the liver and spleen, appear by the end of the 1st week.

Septic salmonellosis- the symptoms of this form are very pronounced and pose a danger to the patient's life. The disease begins with a strong fever, and in the future the condition of the patients is constantly deteriorating. Patients show the following signs of salmonellosis:

profuse sweating;
significant daily fluctuations in body temperature;
severe chills;
the formation of purulent foci in the musculoskeletal system;
endocarditis and aortitis with subsequent development of an aneurysm;
tonsillitis, the appearance of cholecysto-cholangitis.

The septic form also leads to other serious consequences: meningitis (most often this is manifested by salmonellosis in children), liver abscess, infection of the ovaries, abscess of the gluteal region. The disease is characterized by a long course and can be fatal, therefore, with any suspicion of salmonellosis, treatment should be started as soon as possible after mandatory consultation with specialists from medical institutions.

Prevention and treatment of salmonellosis

Inpatient treatment is indicated for patients with severe and moderate forms of salmonellosis. They are prescribed calcium preparations (lactate, gluconate, glycerophosphate), non-steroidal anti-inflammatory drugs. To remove toxins, patients should take drugs based on cellulose and attapulgite, proteolytic enzymes, and cytoprotectors. Antibiotics are used to destroy pathogens: nitrofuran agents and quinolines - with a mild course; fluoroquinolones, ofloxacin, ciprofloxacin, cephalosporins - in severe cases.

To speed up the treatment of salmonellosis and achieve the best results, patients are prescribed: a strict diet, courses of biological products, vitamin therapy, astringents, enveloping and carminative drugs. We also note that salmonellosis, the treatment of which was carried out correctly, does not lead to serious consequences, therefore, if any unpleasant symptoms appear, you should immediately consult a doctor for tests and an accurate diagnosis.

Prevention of salmonellosis is aimed at preventing the spread of pathogens among domestic animals and birds, observing the sanitary regime at public catering establishments and the food industry, and proper heat treatment of products before eating them.

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Salmonellosis is an acute intestinal infection that affects children and adults.

The disease is characterized by the development of general intoxication and the presence of foci of inflammation in the organs of the digestive system. Pathology is easily transmitted from person to person, which often causes epidemics. The first symptoms of salmonellosis should be a signal to go to the nearest hospital for a thorough diagnosis and treatment with pharmacological drugs.

Therapy carried out at the initial stage of an infectious disease contributes to a quick recovery and avoids dangerous consequences.

The causative agent of salmonellosis

The causative agent was first discovered at the beginning of the 19th century in the organs of a deceased person and the meat that he had consumed the day before. In the future, all diseases with similar symptoms began to be combined under the name "salmonellosis".

There are about 100 species of salmonellosis pathogens that are pathogenic to humans, but the most common are Salmonella typhimurium, S.enteritidis, S.panama, S.infantis, S.newpart, S.agona, S.derby, S.london, S.paratyphi A /B, S.schotmuelleri.

The course and danger of the disease is due to the following pathogenicity factors:

1. Flagella (H-antigen) are located on the periphery of the pathogen, they cause movement

2. Capsule (K-antigen) explains protection against phagocytes

3. Inferiority of phagocytosis predisposes to the development of sepsis

4. Features of invasion (introduction) make the penetration of the pathogen almost unhindered into deep tissues

5. Adhesion (fastening) due to fibrils, pectins, LP-saccharide complex

6. The presence of exotoxins (waste products excreted during life):

thermolabile exotoxin = enterotoxin, carries out its mechanism of action by activating the cascade of the enzyme system (adenylate cyclase), cAMP is activated - this causes the release of Na and Cl from the intestinal cells, and after them, along the concentration gradient, water enters the intestinal lumen, and this is how diarrhea is formed with further dehydration,
thermostable exotoxin mediates its action through guanylate cyclase, this entails the phenomenon of rapid vascular permeability, cytotoxin causes damage to epithelial cells

7. Endotoxin is a biologically active substance released after destructive phagocytosis. In this case, endotoxin is a lipopolysaccharide complex and it plays a major role in the formation of intoxication:

causes delayed and immediate hypersensitivity
reduces the degranulation of neutrophils and the release of biologically active substances
activates the synthesis of prostaglandin and thromboxane - this triggers platelet aggregation in small capillaries, inflammation develops, DIC (disseminated intravascular coagulation). Prostaglandins in addition, like enterotoxin, stimulate the secretion of Na and Cl, and also cause smooth muscle contraction and intestinal motility.

Salmonella are relatively resistant to various environmental factors:

At room temperature, it can be stored on household items for up to 3 months;
In dry feces of animals up to 4 years;
In water up to 5 months, in meat and dairy products up to 6 months, in eggshells up to 24 days;
High temperatures are practically not harmful, because salmonella almost instantly die only at 100 ° C, at 70 ° for 30 minutes. Resistance to high temperatures increases when the pathogen is found in meat products (400 g of meat with a thickness of 19 cm must be boiled for 2.5 hours, only after that the meat can be considered safe). Salting and smoking have practically no effect on salmonella.
The resistance of the pathogen is also noted to low temperatures, down to -80 ° C;
UV resistance;
When treated with disinfectants, it dies within 20 minutes.

Susceptibility is ubiquitous, without gender, age and territorial restrictions. But the greatest risk of morbidity among children is within a year from the moment of birth, due to the imperfection of immunity. Salmonellosis occurs throughout the year, but sporadic outbreaks occur more frequently during the summer months.

How can you get infected?

The primary source of infection are farm animals - cattle, pigs, horses, sheep, as well as waterfowl wild birds, in which salmonellosis is asymptomatic. These animals are able to excrete the pathogen with urine, feces, milk, saliva for years and be a source of infection for the person caring for them during transportation, processing and storage of carcasses. Recently, unfavorable sanitary conditions for keeping chickens have led to an increase in cases of human infection with salmonellosis through chicken eggs.
The source of infection for a person is either a patient with salmonellosis or a bacteriocarrier that has no signs of the disease. When infected from person to person, the mechanism of transmission is mainly fecal-oral, that is, through dirty hands, only in rare cases contact-household - when caring for the sick, in a close team, especially in a hospital, kindergarten.
A large percentage of cases of human infection occurs through food - meat of birds, animals, fish, ready-made thermally unprocessed products - salads, fruits, confectionery products, beer.

Infection is especially dangerous for children under one year old, since this can lead to severe generalized forms of salmonellosis, the treatment of which in babies presents serious difficulties. As the child grows, his susceptibility to salmonella decreases. Any intestinal infections have seasonal fluctuations, therefore, in the hot, warm season, epidemiological outbreaks are most often observed.

What happens when salmonella enters the body?

With contaminated foods, the bacterium enters the stomach. This is the first natural barrier to infection - Salmonella die in an acidic environment.

If this barrier is overcome, then the bacteria enter the small intestine. Part of Salmonella is destroyed, releasing endotoxin - from that moment on, the first symptoms of the disease appear: chills, fever, joint and muscle pain, and then vomiting, abdominal pain and loose stools.

The remaining bacteria are captured by intestinal epithelial cells, and then by macrophages - cells designed to engulf, destroy infectious agents and pass their "identification marks" to other immune cells to produce antibodies. In macrophages, Salmonella not only remain viable for some time, but are also able to multiply, and together with them enter the bloodstream, and then are transferred to the lymph nodes, liver, spleen, lungs, kidneys and other organs, where they are fixed.

Under the action of immune forces, the bacteria at the site of fixation either die completely, or provoke the appearance of new foci of inflammation - in this case, rare typhoid or septic forms of salmonellosis develop.

Symptoms of salmonellosis in adults and clinical forms

general weakness;
headache;
an increase in body temperature up to 40 degrees and above;
nausea, vomiting;
pain in the umbilical region;
stool disorders.

high fever and fever lasting more than 5 days;
severe intoxication;
fetid, watery stools (10 times a day or more), sometimes with an admixture of mucus;
skin cyanosis;
a significant drop in blood pressure;
tachycardia;
enlargement of the liver and spleen;
changes in the kidneys (albuminuria, oliguria, high nitrogen content;
acute renal failure.

profuse sweating;
significant daily fluctuations in body temperature;
severe chills;
the formation of purulent foci in the musculoskeletal system;
endocarditis and aortitis with subsequent development of an aneurysm;
tonsillitis, the appearance of cholecysto-cholangitis.

Salmonellosis in children

Signs of salmonellosis in children usually appear 3-4 days after infection of the body. The child feels tired, his body temperature rises, vomiting appears, loose stools up to 5-6 times a day. As the pathology develops, dizziness and headache may occur. Over time, the body temperature rises to 38-39 ° C, the frequency of stool reaches 9-12 times a day, the color of the stool becomes greenish. If timely treatment is not carried out, on the seventh day of illness, mucus appears in the feces, often with blood. Infants with the disease constantly sleep.

When the first symptoms of salmonellosis appear in children, it is necessary to seek help from a doctor. This is very important, since in the first two days from the onset of the disease, a simple blood culture method can be diagnosed. Later, a more complex analysis is done, the results of which must be expected for three days.

Treatment of salmonellosis in children is usually carried out at home. Only in severe cases the child is hospitalized. During the treatment of an infant, it is best to feed with mother's milk or an artificial mixture familiar to him. The diet of older children should consist of easily digestible food. The child needs to provide frequent drinking regimen to avoid dehydration of the child's body.

Features of salmonellosis in pregnant women

A woman's immunity is weaker during pregnancy, so the likelihood of contracting salmonellosis and other infections is higher.
Intoxication and dehydration develop much faster. They exacerbate toxicosis and other pathological conditions.
Salmonella can cross the placenta and infect the fetus. This poses a great danger.
Many drugs used to treat salmonellosis are contraindicated during pregnancy.
In this regard, the treatment of salmonellosis in pregnant women, on the one hand, should be as effective as possible and, at the same time, very careful not to harm the child.

Until the gestational age of 5 months, a woman should be treated only in a hospital.

Diagnosis and analysis for salmonellosis

Upon initial contact with a patient suffering from salmonellosis, it is necessary to carefully differentiate the clinical manifestations present in a person with symptoms of other diseases accompanied by diarrheal syndrome in the form of shigellosis, escherichiosis, cholera, poisoning with any substance. A small number of somatic diseases, which include myocardial infarction, acute appendicitis, an attack of gallstone disease, thrombosis of mesenteric vessels, can simulate the course of salmonellosis.

The fundamental link in the laboratory diagnosis of salmonellosis is the isolation of bacteria by the method of sowing vomit or feces, and in the situation of the development of a generalized form of salmonellosis - blood. In addition, urine, intestinal washings, and bile can act as biological material for further bacteriological analysis.

If a patient develops signs of septicopyemic salmonellosis, purulent contents or exudate from foci of inflammation should be used as biological material for research. To carry out epidemiological control of outbreaks of salmonellosis among adult and pediatric patients, it is necessary to carry out bacteriological studies of food residues that are doubtful in terms of infection, as well as to conduct a thorough analysis of washes from dishes.

When carrying out bacteriological seeding of laboratory material for salmonella content, it is mandatory to use special enriched nutrient media such as magnesium or selenite, as well as Endo or Ploskirev differential diagnostic nutrient media. Also, among the diagnostic laboratory measures, biochemical tests using a complex of monovalent O - and H-sera have sufficient information in relation to the verification of salmonellosis.

Serological tests in the diagnosis of salmonellosis are exclusively retrospective and involve an indirect hemagglutination reaction with complex or group specific erythrocyte diagnosticums at intervals of seven days. The minimum diagnostic antibody titer for this serological test is 1:200.

Currently, most diagnostic laboratories not only of a virological or microbiological profile have equipment that allows for express diagnostics of salmonellosis based on the determination of specific antigens of the pathogen by enzyme immunoassay.

As a determination of non-specific laboratory markers of the intensity of dehydration, such laboratory indicators as hematocrit, hemoglobin concentration, electrolyte composition of the blood are used.

How to treat salmonellosis

How to treat the disease, only a doctor can decide. Most cases of salmonellosis are treated in a hospital. In the case of mild forms of the disease, treatment can be carried out at home. However, this is rather an exception, since salmonellosis is an insidious disease, and its apparent mild course can be replaced by an exacerbation at any time.

Leading directions in the treatment of salmonellosis:

Diet therapy. It is necessary to exclude all foods that irritate the stomach and intestines (strong broths, cabbage, muffins, legumes, radishes, radishes, smoked meats, spicy dishes, etc.), as well as dairy products, fats. However, you can not starve, as this can worsen the course of intestinal recovery processes.
Antibiotic therapy (antimicrobial drugs, salmonella bacteriophages). These funds are used mainly in severe cases, as well as in patients belonging to risk groups (infants, the elderly, people with immunodeficiency states) and decreed groups (food workers, doctors, etc.).
Rehydration and detoxification therapy. Patients are prescribed various saline solutions, enterosorbents.
Restoration of intestinal microflora with the help of bacterial preparations.

With mild salmonellosis, treatment is mainly symptomatic. If a person has gastrointestinal salmonellosis, then the main attention is paid to the rehydration of the body, that is, the restoration of the lost fluid. For this purpose, water-salt solutions are used. Also, in the first days of the disease, gastric and intestinal lavages are regularly done, sorbents are used that absorb bacteria and their toxins, detoxification therapy is carried out using colloidal solutions. Enzyme preparations (pancreatin, dry bile) are used to restore digestive functions.

In addition, it is necessary to take drugs - probiotics, restoring the normal intestinal microflora.

The patient should drink as much liquid as possible. A starvation diet is not indicated; instead, a sparing diet should be used - boiled dishes, low-fat soups, cereals. It is not recommended to take antidiarrheal drugs such as Loperamide, as they slow down the elimination of toxins from the body and can lead to severe intoxication.

Antibiotics for mild salmonellosis are rarely used. This is due to the fact that Salmonella are highly resistant to most antibacterial drugs and because antibiotics can aggravate intoxication. However, for severe salmonellosis, treatment may include antibiotics. Antibiotics are also used in cases where other forms of therapy show low efficiency. Most often, fluoroquinolones are used in the treatment of salmonellosis, but only a doctor can prescribe a specific type of antibiotic. There are also special preparations containing bacteriophage viruses that are active against Salmonella.

There is no vaccination against salmonellosis. This is due to the fact that there are a huge variety of bacteria that can cause salmonellosis - several hundred, and in this case it is impossible to develop a universal vaccine. In addition, immunity to salmonellosis in humans is usually unstable and disappears after about a year.

After recovery, a recovery period follows, which can take several months. This will help to avoid the negative consequences of salmonellosis.

Recovered patients, however, can carry Salmonella in their bodies for a long time and can be dangerous to others due to the possibility of infecting them. Also, the consequences of salmonellosis include dysbacteriosis, which is subject to treatment with probiotic preparations.

What are the consequences of salmonellosis?

Serious consequences of salmonellosis is dehydration, it occurs especially quickly in children.

Consequences can occur only after the transfer of moderate and severe forms of the disease, especially typhoid-like and septic varieties. Complications such as toxic shock, acute heart failure, liver failure, cerebral edema, urinary and biliary tract infections, pneumonia are observed only in severe septic cases. The most formidable is toxic shock and toxic gut, which can be obtained if you try to stop diarrhea with imodium or loperamide.

However, even after the disease has been transferred in a mild typical form, the body needs time and favorable conditions for recovery, since salmonellosis disrupts water-salt metabolism, absorption of nutrients, trace elements and vitamins, and weakens the immune system.

How to avoid infection: prevention

The rules for cooking in canteens are controlled by the SES, but it is quite possible to use them at home.

Knives and cutting boards for meat and products not intended for heat treatment should be different. And after use, it is advisable not just to rinse them, but to wash them thoroughly and pour boiling water over them.
Meat "with blood" may well cause infection. Meat or poultry that have been cooked for an hour are considered safe.
Eggs should be boiled for at least 10 minutes, and if a dish of raw eggs is planned, then they should be thoroughly washed with soap and water.
Milk that is not packed in a sterile container should not be drunk unboiled.
Ready-made products should be stored in the refrigerator, and before eating, be sure to boil or fry.
Of course, the rule “my hands before eating” must be strictly followed.

The rules of prevention are simple and familiar from childhood, but those who have encountered intestinal infections, which include salmonellosis, understand how important it is to follow them.