Salmonellosis - intestinal infection caused by numerous pathogens of the genus Salmonella what is amoxil used for, characterized by clearly pronounced intoxication and gastrointestinal symptoms.
Salmonella tolerate freezing, drying, survive in water up to two months, accumulate in meat and dairy products that are resistant to the salted, smoked, marinades. When boiling rapidly destroyed.
The main sources of infection are animals, occasionally men. The duration of the hidden currents of salmonellosis in animals can go on for years. Asymptomatic disease found in many species of farm animals, cats, dogs, rodents, birds.
The main route of infection - the food, and the factors of transmission may be different foods - meat of mammals, birds, fish, eggs and egg products, milk and dairy products, etc. The second mode of transmission -. Water where the transmission factor is water of open reservoirs or tap water in emergency conditions.
Salmonella, overcame the barrier of the stomach, to quickly penetrate into the mucous membrane of the small intestine. Vital functions of Salmonella in the gut mucosa accompanied by production of toxins, which are responsible for the development of diarrheal, pain and symptoms of intoxication.
The manifestations of salmonellosis
The incubation period for salmonellosis varies from 6 hours to 2-3 days, averaging 12-24 hours. Often the disease begins acutely: chills, fever up 38-39S, headache, weakness, malaise, cramping abdominal pain, nausea and vomiting. Stool thin, watery, frothy, foul-smelling, greenish from 5 to 10 times a day. On the 2-3 th day of the disease in some patients in the stool detected an admixture of mucus, and (rarely) blood. The duration of the disease in most cases, from 2 to 10 days.
Complications include peritonitis, toxic colon expansion, reactive arthritis, infectious-toxic and dehydration shocks.
Salmonella typhoid embodiment usually begins with signs of lesions of the gastrointestinal tract, but can occur at the outset and bowel function without disturbances. The duration of fever ranges from 10-14 days to 3-4 weeks. The temperature often reaches 39-40S. The skin of patients with pale, sometimes on the abdomen and torso rash found items.
Gastrointestinal form (acute gastritis, acute gastroenteritis or gastroenterocolitis) - one of the most common forms of salmonellosis (96-98% of cases). Begins acutely, the body temperature rises (in severe forms to 39oS and above), there are general weakness, headache, chills, nausea, vomiting, pain in the epigastric and umbilical areas, later joined by frustration of a chair. Some patients initially observed a fever and signs of intoxication, and changes in the gastrointestinal tract join later. They are most pronounced at the end of the first and on the second and third days of the onset of the disease. The severity and duration of symptoms of the disease depend on the severity.
In mild form of salmonellosis body temperature of low-grade, single vomiting, watery liquid stools up to 5 times per day, duration of 1-3 days of diarrhea, fluid loss of no more than 3% of body weight. At moderate form salmonellosis 38-39oS temperature rises to, the duration of fever up to 4 days, repeated vomiting, chair to 10 times per day, the duration of diarrhea to 7 days; marked tachycardia, low blood pressure, dehydration may develop I-II degree, fluid loss of up to 6% of body weight. Severe gastrointestinal form of salmonellosis is characterized by high fever (above 39oS), which lasts 5 days or more, severe intoxication. Vomiting multiple, observed for a few days; chair more than 10 times a day, copious, watery, fetid, can be mixed with mucus. Diarrhea lasts up to 7 days or more. There enlarged liver and spleen, can ikterichnost skin and sclera. Observed skin cyanosis, tachycardia, a significant reduction in blood pressure. To detect changes in the kidneys: oliguria, albuminuria, red blood cells and the cylinders in the urine, increased residual nitrogen content. May develop acute renal failure. Violated the water-salt metabolism (dehydration degree II-III), which is manifested in the dryness of the skin, cyanosis, aphonia, seizures. fluid loss reached 10.7% weight. In the blood increases the level of hemoglobin and red blood cells, characterized by mild leukocytosis with a shift leukocyte left.
The most frequent clinical variant with the gastrointestinal salmonellosis gastroenteritis. Destructive changes in the colon (catarrhal-hemorrhagic) recorded only in 5-8% of cases. Gastroenterokoliticheskie and colitis variant of the disease should be diagnosed only if the clinical picture of the disease is dominated by symptoms of colitis and has bacteriological or serological confirmation of the diagnosis, as these options are very similar salmonellosis downstream from acute dysentery.
Tifopodobnaya option generalized form. The disease often begins acutely. In some patients, the first symptoms of the disease may be gastrointestinal disorders, coupled with fever and general intoxication, but after 1-2 days pass intestinal dysfunction, and body temperature remains high, growing signs of intoxication. The majority of patients at the beginning and course of the disease similar to typhoid and paratyphoid fever A and B can be a constant type, but often wavy or remittent. Patients inhibited, apathetic. The face is pale. In some patients, 2-3-day herpes rash appears, and a 6-7-day - roseolous preferentially localized rash on the skin of the abdomen. There is a relative bradycardia, low blood pressure, cardiac muted tones. Above the light scattered dry rales are heard. Bloating. By the end of the 1st week of illness appears enlarged liver and spleen. The duration of fever 1-3 weeks. Recurrences are rare.
Septic form - the most severe variant of generalized salmonellosis. Disease begins acutely, in the early days it has tifopodobnaya for. In the future, the condition of patients worsens. The body temperature becomes irregular - with large daily scope, chills repeated and profuse sweating. The disease is usually hard, responds poorly to antibiotic therapy. The secondary septic lesions can form in various organs, so that the clinical manifestations of salmonellosis options are very diverse, and its diagnosis is difficult. Formed purulent focus in the symptoms comes to the fore. Purulent lesions often develop in the locomotor system: osteomyelitis, arthritis. Sometimes there are bacterial endocarditis, aorta with subsequent development of aortic aneurysm. Relatively often arise cholecysto-cholangitis, tonsillitis, suppurative cervical lymphadenitis, meningitis (the latter usually in children). Less commonly observed purulent lesions at other sites, such as liver abscess, infection of ovarian cysts, Salmonella strumitis, mastoiditis, abscess gluteal region.