Salmonella, what is it? Symptoms and Treatment Scheme

Salmonellosis is a polyetiological disease, the cause of which is the development of various types of bacteria in the Salmonella group.

Difficulties with diagnostics can arise due to the fact that the pathology can proceed latently without inducing a malaise in the patient. But there are cases of severe disease, when there was a development of serious gastroenterological diseases.

Salmonella sticks can settle and multiply in the body of both animals and humans. They are very resistant to environmental influences, so they are able to maintain their vital functions in completely different conditions.

People can suffer from salmonellosis all over the world, but most of all it is common in megacities and developed countries.

Characteristics of the pathogen

Salmonella belongs to the genus of gram-negative, mobile, facultative anaerobic, rod-shaped bacteria. They are able to maintain their viability in various environmental conditions:

in water - no more than 5 months;
in the soil - about 1.5 years;

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in meat - up to 6 months;
in poultry carcasses - about 12 months (but sometimes more);
in milk - up to 20 days;
in kefir or yogurt - about a month;
in butter - about 4 months;
in cheese - up to a year;
in egg powder from 3 to 9 months;
in the eggshell - from 17 to 24 days.

Salmonella perish under the influence of high temperatures, but they are able to maintain life for 5-7 minutes of boiling. It is especially difficult to destroy these bacteria if they are in the thickness of layers of a large piece of meat.

These microorganisms are resistant to salting and smoking, and freezing meat or fish and at all contributes to the extension of their life. To date, there are hospital strains of these bacteria that do not die completely even with antibiotic therapy and antiseptic treatment. The carriers of Salmonella are livestock, poultry, and also some wild animals. They, like people, pathology can be absolutely asymptomatic. However, not all animals are susceptible to salmonella infection, but only those whose immune system functions quite poorly. Consequently, healthy fauna representatives practically never suffer from salmonellosis.

When penetrating the blood, salmonella begins to spread throughout the body, seeding the internal organs and tissues. A person can pick up an infection when caring for an animal, cutting meat or eating it. Birds infected with salmonella contaminate the external environment with litter, which, when contacted, also infects humans. But not always carriers of these microorganisms are animals - people too can carry an infection. Animals can be carriers of Salmonella for several months, people - from 3 weeks to several years.

Basically, salmonellosis is transmitted through eating meat or eggs, but cases of ingestion of salmonella sticks into drinking water are known. The bacterium also easily spreads through the milk of the infected animal. In large cities, these microorganisms can be carried by air and enter the human body after inhaling dusty air containing a stick of salmonella. Especially susceptible to these representatives of pathogenic microflora are infants and preschoolers, as well as people in advanced age and people with immunodeficiency. Despite the fact that after the transferred salmonellosis a person develops immunity to it, the protective reaction of the body is temporary and lasts no more than a year.

The incubation period

The incubation period of salmonellosis can range from 6 hours to 3 days. On average, it lasts about half a day or a day.

How much time has passed since the moment of infection, the course of the disease from this will not change. If the infected person manifested the first symptoms, they will grow as the pathology develops. But provided that it was asymptomatic from the very beginning, then in the future it may not manifest itself in any way. This is much worse, because in such a situation a person will be a source of infection for others.

Symptoms

The clinical manifestations of salmonellosis in adult patients depend on the form in which the pathology proceeds. There are 5:

gastrointestinal;
typhoid-like;
asymptomatic;
bacteriocarrier;
septic.

Each of these forms has its own peculiarities of manifestation, which you need to know about, because no one is insured against salmonellosis.

Gastrointestinal form

This is the most common form of salmonella, which has a fairly pronounced clinical picture. First of all, the patient exhibits acute signs of intoxication of the body:

general weakness;
dizziness;
cephalgia;
febrile (38-39 degrees) or pyretic (39-40) fever;
chills and shivers all over the body.

The clinical picture of the disorder in the gastrointestinal tract progresses rapidly:

Initially, the patient suffers from pain in the stomach, near the navel;
after a while, an abundant vomiting opens up, while in the vomit masses the partially digested food particles are clearly traced;
after a while, vomiting becomes watery, possibly the appearance of bile impurities;
the patient develops diarrhea with greenish feces and mucous membranes, foamy inclusions.

During physical examination, dryness and presence of a white coating on the tongue are noted, as well as abdominal tenderness during palpation. Pressing on the abdomen marks his bloatedness. This form of salmonellosis is also accompanied by an increase in the liver and spleen.

Termination of diarrhea occurs 3-5 days after the onset of the pathology, but during this time it can lead to dehydration of the body. To avoid this, the patient should drink as much as possible.

Other unpleasant consequences of diarrhea in salmonellosis are:

metabolic disorders in the patient's body;
great loss of mineral salts;
convulsions;
hypotension;
tachycardia;
syncope or presyncope;
bouts of vertigo.

As a rule, the symptoms of salmonellosis go through 5 days, but a full recovery may take 10 to 14 days. This form of the disease has 2 degrees of severity:

An easy degree is characterized by the absence or slight increase in body temperature. The patient may be disturbed by rare attacks of vomiting and diarrhea. Often by day 3, the symptomatology of the pathology completely passes.
Severe degree, which is characterized by a longer malaise (3-5 days). The patient is disturbed by frequent vomiting and diarrhea, a sharp drop in blood pressure and a decline in strength.

The severe degree of gastrointestinal form of salmonellosis is similar to that of dysentery.

Typhoid-like form

The initial symptoms are almost the same as with gastrointestinal form, but after a while the clinical picture begins to resemble the symptoms of typhoid fever. During the week, the patient suffers from fever and general intoxication of the body. The patient can be delirious, hallucinations begin to arise.

On the 6th-7th day of the disease, a red rash appears on the abdomen, which passes through 2-3 days. The patient's tongue becomes gray-brown, the skin pales, the liver and spleen increases. The patient suffers frequent attacks of meteorisms, the stomach is constantly swollen.

This form of salmonellosis is difficult to win, so a full recovery can be expected only after a month or one and a half.

Asymptomatic form

Such a form of salmonellosis occurs when a small number of salmonella sticks are introduced into the human body. Due to a strong immune system, pathogenic microorganisms are neutralized without causing harm to health. This is the reason for the complete absence of symptoms.

Bacteriogenesis

After infection with salmonella, a person can be its carrier and distributor, without knowing it himself. The wand is excreted together with feces for 3 months, but this period may be shorter.

Septic form

This is a fairly rare variety of salmonella, affecting mainly elderly people, immunocompromised individuals and newborn infants. This form of pathology is characterized by a prolonged febrile state, hyperhidrosis, chills and tremors in the body, development of jaundice and abscess in tissues and organs.

The septic appearance of salmonella is one of the most dangerous, since there is a high risk of death. It is explained by the fact that suppuration in tissues and internal organs leads to the development of sepsis, which proceeds in a chronic form.

Complications of salmonellosis

Salmonella is dangerous not only for its symptoms and its ability to involve various internal organs in the pathological process. In the absence or untimely beginning of treatment, serious complications may occur.

Gastrointestinal form of pathology can be complicated by the development of collapse or hypovolemic shock. This pathological condition is accompanied by a fall in blood pressure, nausea, vomiting, dizziness, syncope, pallor of the skin.
Development of acute heart failure.
Suppuration in the joint, bone and soft tissues.
Purulent abscesses in the spleen and liver.
Endocarditis.
Violation of the kidneys of the urinary system - cystitis, pyelonephritis, etc.
Abscess of the brain.
Meningitis.
Development of peritonitis, acute appendicitis.
Less often, salmonellosis can cause pneumonia.

In most cases, salmonellosis results in complete recovery, but in rare cases it leads to death.

Salmonellosis in children

In newborn babies and small children (1-3 years old), infection with salmonella appears much sharper and heavier than in adults. This is due to the fact that their immunity is still not strong enough to combat the pathogenic microflora, which contributes more rapid development of such dangerous anomalies as dehydration, diarrhea, vomiting and convulsions caused by them.

Important! If you do not seek medical help in a timely manner, the condition of the sick child can significantly worsen over a period of several hours after the first signs of the disease manifest.

Salmonella in newborns is characterized by the dominance of common symptoms over signs of lesions of the gastrointestinal tract. The child in this case becomes sluggish, apathetic, he is tortured by intestinal colic, he has no appetite and, accordingly, he loses weight. Vomiting, nausea and diarrhea in the baby may not be, but rapidly spreading through the body the infection can cause the development of meningitis syndrome.

Salmonella during pregnancy

Salmonellosis in pregnant women has its own causes and features of manifestation.

In pregnancy, immunity is significantly weakened, which facilitates free entry of Salmonella and other microorganisms into the blood.
Dehydration and general intoxication of the body occurs much faster, which often leads to increased symptoms in toxicosis.
Salmonella can cross the placenta cells, hitting the fetus.
Most medications used to treat salmonellosis are strictly prohibited during pregnancy.

Proceeding from this, therapy for salmonellosis in pregnant women should pursue two goals: to be as effective and as safe as possible for the fetus. To avoid severe complications, the treatment of pathology before the onset of 5 months of pregnancy is carried out exclusively in a hospital.

Diagnostics

Preliminary diagnosis is made on the basis of complaints, as well as the number of cases. As a rule, salmonellosis affects a whole group of people at once, which is one of the main reasons why a doctor can suspect that this disease is present in patients. But to confirm the diagnosis to the patient, nevertheless, you will have to pass certain tests:

Bacteriological study of samples of stool and vomiting. Also, a part of the food product that the patient could poison could be examined.
Serological test, during which the presence of antibodies in the patient's blood to a stick of salmonella is detected.

Salmonellosis: treatment

If the disease is severe, the patient may be hospitalized. Typically, inpatient care is indicated for the elderly, infants, people with weak immunity, food workers, pregnant women and medical personnel.

In most cases, the therapeutic approach involves the use of:

Dietotherapy. It assumes a complete exclusion from the diet of foods that irritate the stomach mucosa: acute, salty, smoked, hot, spicy.
Antibiotic therapy, which is conducted exclusively in extreme cases. As a rule, those groups of patients who are hospitalized in a hospital are exposed to it.
Rehydration and detoxification. Patients are prescribed drugs based on saline (Regidron) and enterosorbents (White coal, Enterol).
Probiotics (Hilak Forte, Bifiform, etc.).

Diet with salmonella

Particular importance is given to diet in adult patients, as it significantly reduces the intensity of salmonella symptoms. When stationary therapy is prescribed dietary table number 4, but if the patient is treated out-patient, he is recommended to give preference:

food, which is quickly absorbed, in small portions, trying to avoid overeating;
apples, bananas, carrots, potatoes;
fermented milk products;
berries (in particular, niello and cranberries);
lemon (in small quantities);
lean meat and fish;
food, steamed;
watermelons;
white breadcrumbs;
water, green tea, fruit compotes and kissels;
broth;
light soups;
semolina porridge;
rice, buckwheat;
porridge without oil and salt;
dairy-free mashed potatoes.

In the first days of treatment, you can only drink water, and then the patient is allowed to include in the diet boiled and baked food.

How to accelerate healing and restore intestinal microflora

To recover faster after illness, the patient should comply with such rules:

For 30 days after the start of therapy, it is necessary to continue to follow the diet.
You can take enzymes from the first day of the disease (Mezim, Festal, etc.).
If there is profuse vomiting, you can take Tserukal or Motilium tablets.
With intensive gastric pain excellent capsule Vis-Nol, papaverine or No-Shpu.
If the patient is suffering from bouts of flatulence, you can apply Espomizan or Colicides.
After cessation of diarrhea, the patient is prescribed drugs that restore the intestinal microflora: Linex Forte, Bifidobacterin, Bifiform, and others. The duration of taking these drugs should be at least 3 weeks.

To the main treatment you can add herbal medicine. Excellent help decoctions from the bark of oak, pomegranate peel, cherry fruit. These plants have an astringent effect. After their application, it is advisable to begin taking infusions of herbs that have anti-inflammatory properties - chamomile, sage, plantain, St. John's Wort, etc.

Rehabilitation and prevention

Methods of prevention, presented below, are classified as nonspecific. The length of stay of patients in a hospital with a localized form of salmonellosis is about 2 weeks, with a generalized form of about a month. Two months after the end of therapy, the patient must undergo a bacterial examination. It repeats twice, and in the absence of a stick of salmonella in the human body is allowed to work.

Persons working in the food industry are subject to medical examination, the duration of which is about 90 days. During this period of time, feces are studied, and with positive results of the analysis the patient should be removed from work and isolated from other people for a period of 15 days. In this case, the patient is transferred to another workplace, and during the period of his work he is given a five-time study of a stool specimen and a single sample of bile. If the salmonella release continues for another 3 months, the patient is transferred to another job, after which the clinical trials continue for a year. A specimen of feces is examined every 6 months, and a year later a five-fold study of the bile sample is made. The interval between the analyzes is 1-2 days. If the results are again positive, the patient is removed from work, if they are negative, they are returned to their previous workplace.

To prevent contamination with salmonella, eggs, meat and fish must be thoroughly heat treated. Also do not forget about personal hygiene. Other methods by which it is possible to prevent infection with Salmonella do not exist, since no specific preventive measures have been developed so far.