Pathogen:
Salmonellae are non-spore-forming, gram-negative rods of the family Enterobacteriaceae. S. typhosa causes typhoid fever; other Salmonella cause diarrhea and bacteremia.
Sites of Infection:
Infection is usually by the oral route and results from ingestion of contaminated food or water. The bacteria multiply after entering the small intestine. Salmonella infections are usually systemic and disseminated in HIV-infected patients. While salmonellosis is an infrequent opportunistic infection in AIDS, the incidence of salmonellosis in AIDS patients is about 20 times higher than in immunocompetent people. Recurrent Salmonella septicemia in HIV-infected adults establishes an AIDS diagnosis.
Symptoms:
Most patients present with non-specific symptoms such as fever, chills, sweats, weight loss, diarrhea, and anorexia. Although enterocolitis is common in AIDS, it is usually not caused by Salmonella.
Diagnosis:
Bacterial culture of stool or blood.
Treatment:
Treatment for immune-competent people is normally supportive; however, in AIDS patients antibiotic therapy is indicated. Ciprofloxacin, ampicillin, chloramphenicol, and TMP/SMX are effective. Relapse is frequent and maintenance therapy with ciprofloxacin may be indicated.
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