Diagnosis of salmonellosis in adults

Characterized by an acute onset with fever, nausea, vomiting, diarrhea, abdominal pain.

[1], [2], [3], [4], [5], [6], [7], [8]

Indications for consultation of other specialists

Consultation of the surgeon is necessary when suspicion of appendicitis, thrombosis of mesenteric vessels, intestinal obstruction.

Consultation of a gynecologist is prescribed for suspected ectopic pregnancy, ovarian apoplexy, salpingo-oophoritis.

Consultation of a cardiologist - to exclude myocardial infarction, hypertensive crisis, correction of therapy with concomitant IHD, hypertension.

Indications for hospitalization

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

Epidemiological diagnosis of salmonellosis

The intake of food prepared and stored with a violation of sanitary standards, the consumption of raw eggs. Group flashes. In megacities, the detection of group cases of the disease presents great difficulties if the product contaminated with salmonella is sold through a trade network or public catering establishments. Without confirmation of the diagnosis by laboratory tests, differential diagnostics of salmonella with foodborne toxic infections presents great difficulties.

[9], [10], [11], [12], [13], [14],

Specific and nonspecific laboratory diagnostics of salmonellosis

Bacteriological examination of feces (one or two times), vomit, blood, urine, bile, rinsing of the stomach, remnants of suspicious products.

Salmonella antigens can be detected in blood and urine with the help of ELISA and RGA. For retrospective diagnostics use the definition of specific antibodies (RIGA and ELISA). The paired sera, taken at an interval of 5-7 days, are examined. The diagnostic value is the increase in titres by four times or more.

Differential diagnosis of salmonellosis

Differential diagnosis of salmonellosis. Dysentery, cholera

Clinical signs	Salmonellosis	Dysentery	Cholera
Chair	Watery, with an unpleasant odor, often with an admixture of greenery of the color of marsh mud	Scanty bezkalovy with an admixture of mucus and blood - "rectal spitting"	Watery, the color of rice broth, odorless, sometimes with the smell of raw fish
Defecation	Painful with a colitis	With the tenesmus	Painless
Abdominal pain	Moderate cramping, in epigastrium or mesogastrium	Strong, with false urges, in the lower abdomen, left iliac region	Not typical
Vomiting	Multiple, precedes diarrhea	Possible with gastro-enterocolitis	Multiple watery. Appears later in diarrhea
Spasm and soreness of the sigmoid colon	Possible with a colitis option	Characteristic	Not marked
Dehydration	Moderate	Not typical	Typical, pronounced
Body temperature	Increased	Increased	Normal, hypothermia
Chills	Typical	Typical	Not typical

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

Clinical signs	Salmonellosis	Acute appendicitis	Thrombosis of mesenteric vessels
Anamnesis	The use of poor-quality food, the possibility of group outbreaks	Without features	IHD. Atherosclerosis
Onset of disease	Acute, with pronounced intoxication, a 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 epigastrium or spilled. Disappears before the cessation of diarrhea or simultaneously with it	Strong constant, worse when coughing. Preserved or intensified upon cessation of diarrhea	Sharp, unbearable, permanent or paroxysmal, without a specific localization
Chair	Liquid, abundant, fetid, with an admixture of greens, multiple	Liquid feces, without pathological impurities, up to 3-4 times. More often constipation	Liquid, often with an admixture of blood
Convulsions, dehydration. Chills	During the height of illness	None	None
Examination of the abdomen	Moderately swollen, rumbles at palpation, painful in epigastrium or mesogasteria	Soreness in right iliac region with muscle tension. Symptoms of irritation of the peritoneum are positive	Will swell, spilled soreness
Vomiting	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, grows	Expressed, grows

[15], [16], [17],

Example of the formulation of the diagnosis

A02.0. Salmonellosis. Gastrointestinal form. Gastroenteric variant. The medium-heavy current.

[18], [19], [20], [21], [22], [23],