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Diagnosis of salmonellosis in adults

, medical expert
Last reviewed: 03.07.2025
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Characterized by an acute onset with increased body temperature, nausea, vomiting, diarrhea, and abdominal pain.

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Indications for consultation with other specialists

A surgeon's consultation is necessary if appendicitis, mesenteric vascular thrombosis, or intestinal obstruction are suspected.

A gynecologist consultation is prescribed if there is a suspicion of an ectopic pregnancy, ovarian apoplexy, or salpingo-oophoritis.

Consultation with a cardiologist - to rule out myocardial infarction, hypertensive crisis, and to correct therapy for concomitant coronary heart disease and hypertension.

Indications for hospitalization

Severe course of the disease, presence of complications; epidemiological indications.

Epidemiological diagnostics of salmonellosis

Eating food that was prepared and stored in violation of sanitary standards, eating raw eggs. Group outbreaks. In megacities, identifying group cases of the disease is very difficult if a product contaminated with salmonella is sold through a retail network or public catering establishments. Without confirmation of the diagnosis by laboratory tests, differential diagnostics of salmonellosis with foodborne toxic infections is very difficult.

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Specific and non-specific laboratory diagnostics of salmonellosis

Bacteriological examination of feces (once or twice), vomit, blood, urine, bile, gastric lavage, and remains of suspicious products.

Salmonella antigens can be detected in blood and urine using ELISA and RGA. For retrospective diagnostics, specific antibodies are determined (RIGA and ELISA). Paired sera taken at intervals of 5-7 days are examined. A fourfold or more increase in titers is of diagnostic value.

Differential diagnostics of salmonellosis

Differential diagnostics of salmonellosis, dysentery, cholera

Clinical signs

Salmonellosis

Dysentery

Cholera

Chair

Watery, with an unpleasant odor, often with an admixture of greenery the color of swamp mud

Scanty, fecal-free stool with an admixture of mucus and blood - "rectal spit"

Watery, rice-colored, odorless, sometimes with a raw fish odor

Defecation

Painful in the colitic variant

With tenesmus

Painless

Abdominal pain

Moderate cramping, in the epigastrium or mesogastrium

Strong, with false urges, in the lower abdomen, left iliac region

Not typical

Vomit

Multiple, precedes diarrhea

Possible with gastroenterocolitic variant

Multiple watery. appears later than diarrhea

Spasm and pain in the sigmoid colon

Possible in the colitic variant

Characteristic

Not marked

Dehydration

Moderate

Not typical

Typical, sharply expressed

Body temperature

Increased

Increased

Normal, hypothermia

Chills

Typical

Typical

Not typical

Differential diagnostics of salmonellosis, acute appendicitis, thrombosis of mesenteric vessels

Clinical signs

Salmonellosis

Acute appendicitis

Mesenteric vascular thrombosis

Anamnesis

Consumption of poor quality food, possibility of group outbreaks

No special features

IHD. atherosclerosis

Onset of the disease

Acute, with severe intoxication, clinical picture of acute gastroenteritis

Pain in the epigastrium with movement to the right iliac region

Acute, less often gradual, with abdominal pain

The nature of abdominal pain

Moderate cramping. In the epigastrium or diffuse. Disappears before the cessation of diarrhea or simultaneously with it.

Severe, constant, worse with coughing. Persists or worsens when diarrhea stops

Sharp, unbearable, constant or paroxysmal, without a specific localization

Chair

Liquid, abundant, fetid, with an admixture of greenery, multiple

Liquid feces, without pathological impurities, up to 3-4 times. more often constipation

Liquid, often mixed with blood

Cramps, dehydration, chills

During the height of the illness

None

None

Examination of the abdomen

Moderately swollen, rumbling on palpation, painful in the epigastrium or mesogastrium

Pain in the right iliac region with muscle tension. Symptoms of peritoneal irritation are positive.

Swollen, diffuse soreness

Vomit

Multiple, in the first hours

Sometimes at the beginning of the disease. 1-2 times

Often, sometimes with an admixture of blood

Leukocytosis

Moderate

Expressed, increasing

Expressed, increasing

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Example of diagnosis formulation

A02.0. Salmonellosis. Gastrointestinal form. Gastroenteric variant. Moderate course.

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