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Salmonella food poisoning or salmonellosis is a common bacterial infection of the intestinal tract which causes diarrhea and abdominal pain.

Salmonella spreads through contaminated food and water. This infection is usually acquired through eating raw or undercooked meat, seafood and poultry. Eating raw eggs is also a common cause of salmonella food poisoning. This bacterium is shed in the feces; therefore drinking contaminated water transmits the bacteria. For the same reason it is more common in underdeveloped countries with poor sanitary measures.

The symptoms of salmonella food poisoning include watery diarrhea, abdominal cramps, fever, chills, nausea and vomiting. These symptoms usually last for a week and usually are self-limiting in most cases. Severe diarrhea can be dangerous in some cases because it can cause significant dehydration. It is therefore advised in all the cases to drink plenty of fluids. Other complications include bacteremia, which means that the bacteria have entered the bloodstream through the intestinal wall. It may also be dangerous and requires a complete antibiotic course.

Salmonella is diagnosed through a stool test which detects the bacterium in a stool sample. If there is a suspicion of bacteremia, a blood test may also be ordered.

Management Of Salmonella Infection

Since the main symptom is watery diarrhea, it may result in dehydration. The treatment focuses on the replacement of fluids and electrolytes that are continuously lost due to diarrhea. Patients are usually advised to drink as much water as they can. Oral rehydration therapy (ORS) can also be recommended, especially in children. Most cases of salmonella food poisoning resolve themselves in four to seven days. If the diarrhea is severe and frequency of stools is very high, an anti-diarrheal medication like loperamide can also be given.

If you have a very severe infection or if the doctor suspects bacteremia, he may advice antibiotics to kill the bacteria. In mild cases, antibiotics are not usually recommended; in fact they may slow the recovery in mild cases. In severe cases, however, the antibiotics are essential. Usually Ciprofloxacin (quinolone) in used as a first line drug for salmonnela infection. Other drugs include azithromycin (macrolide) and third generation cephalosporin.

Possible Causes Of Treatment Failure Or Relapse

Sometimes there is no improvement after a week or two or there is a relapse of the same symptoms; in that case, there can be following possible explanations;

  • The bacteria are resistant to the antibiotic you have been taking, which means the bacteria are not sensitive to that antibiotic. Some strains of bacteria develop the ability to withstand a certain antibiotic. It is known as “antibiotic resistance”. It is one of the major problems in treating infectious diseases today. The resistance of salmonella to fluoroquinolones (ciprofloxacin) is increasing day by day.

Your doctor may advise you to take a different antibiotic, like macrolide or cephalosporin. This will most probably prove effective.

  • Non-compliance is another important cause. It means that you did not take the medication properly as advised or you missed too many doses. This results in an incomplete eradication of bacteria, which then causes a relapse after some time.
  • You may actually have another attack of food poisoning most probably by some other bacteria, especially if you are not eating right.

In short, take the complete course of antibiotics as advised. In case of a relapse, immediately contact your doctor. The doctor may advise another antibiotic if needed.

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