Description

Chiu et al studied patients with non-typhoidal Salmonella infections who developed extraintestinal infections (EII). A patient with nontyphoidal Salmonella gastroenteritis and risk factors for EII may benefit from prophylactic antibiotics to reduce the probability of invasive disease. The authors are from Chang Gung University in Taoyuan, Taiwan.


 

Patient selection:

(1) infection with Salmonella species other than S. typhi

(2) not AIDS-related

Gastroenteritis

Focal Infection

Bacteremia

Type EII

absent

present

absent

localized infection

absent

present

present

primary bacteremia

absent

absent

present

primary bacteremia

present

present

present

secondary bacteremia

present

absent

present

secondary bacteremia

present

present

absent

localized infection

 

where:

• There are 8 combinations for gastroenteritis, focal infection and bacteremia.

• Gastroenteritis without focal infection or bacteremia (present, absent, absent) was considered intestinal disease.

 

Risk factors in pediatric patients:

(1) age < 3 years of age

(2) WBC count either < 5,000 per µL or > 15,000 per µL

(3) immature neutrophil forms > 10% of the peripheral blood differential count

(4) C reactive protein > 50 mg/L

 

Risk factors in adults:

(1) underlying disease, especially immunosuppression, cirrhosis, diabetes mellitus or cancer

(2) age >= 60 years

(3) presence of an invasive serotype (high invasion index) such as choleraesuis, Norwich, or Dublin

 

Limitations:

• The authors refer to anyone >= 60 years of age as being old.

 


To read more or access our algorithms and calculators, please log in or register.