Salmonella is a group of more than 2000 bacteria that are gram-negative, rod-shaped and actively mobile. They belong to the genus Salmonella and mostly infest the intestine (Entereobactrericeae). Salmonella belongs to the zoonoses, i.e. a transmission from human to animal or vice versa is possible. Salmonella can also be transmitted by a smear infection. Diseases caused by salmonella can be divided into “typhoid salmonellosis” and “enteric salmonellosis”.
Typhoid salmonellosis
Result: generalized, septic clinical picture (severe fever and considerable feeling of illness) Treatment: antibiotics always necessary
- Are caused by Salmonella TyphiParatyphi (Typhoid/Paratyphoid)
- Are absorbed via food/water and penetrate the lymphatic system via the gastrointestinal tract
- Infection via human excreta, contaminated water, contaminated food
Enteric salmonellosis
Mostly no antibiotic therapy necessary!
- Are caused e.g. by Salmonella Enteritidis or S. Tymphimurium
- Colonize only the intestine in case of infection -> diarrhea with vomiting and fever
- Infection often via farm animals
- Infection but also via human excreta, contaminated water, contaminated food
In 1880 Robert Koch found the pathogen causing typhoid fever abdominalis. In 1884 Georg Gaffky was able to breed Salmonella in culture for the first time1885 the pathogen of “swine cholera” was discovered by Daniel Elmer Salmon The genus Salmonella was named after him.
Typhoid Salmonella occurs only very sporadically in Northern and Central Europe. They are usually imported by travelers. An accumulation occurs only in concatenation of unfavorable circumstances (e.g.
high water + high temperatures + bad hygienic conditions, e.g. after natural catastrophes like hurricanes). Enteric salmonella, on the other hand, is increasing in frequency worldwide. The most important source of infection here is farm animals.
From there, the pathogens are transmitted via food (raw eggs, raw poultry meat, milk, mussels). Often a group disease (e.g. family, canteen) is caused by the joint consumption of contaminated products. Typhoid Salmonella have an incubation period of 1-3 weeks.
The first symptom is a stair-like rising fever, which first rises to 39°C, then to 40°C, and finally to 41°C. In addition, there is abdominal pain and headache, dizziness, swelling of the spleen, reduction of white blood cells (leukopenia) and slowing of the heartbeat (bradycardia). Diarrhea (diarrhea), possibly with intestinal bleeding, can occur from the 3rd week of illness.
Enteric Salmonella have an incubation period of 1-2 days. Acute diarrhea and fever occur first. Improvement can occur within a few days without specific therapy, i.e. Enteric Salmonella are self-limiting.
In cases of massive diarrhea and/or vomiting, especially in infants, toddlers and seniors, water and electrolyte losses (loss of body salts) with corresponding symptoms may occurTyphotic Salmonella are detectable in blood, urine and stool. Antibody detection is also possible. Enteric Samonella are only detectable in stool.
For both pathogen types it is possible to cultivate them on special media and thus detect them. However, this usually takes at least 2 days. Typhoid Salmonella must be treated with antibiotics.
The active ingredients aminopenicillin (e.g. Amoxi-CT®, Amoxicillin acis®, AmoxiHEXAL® , Ampicillin-ratiopharm®), fluoroquinolone (e.g. Ciprobay® , Avalox®, Actimax®), chloramphenicol (e.g.
Chloramphenicol (e.g. Paraxin®). In the case of an infection with enteric Salmonella, antibiotic therapy is only necessary in exceptional cases (e.g. severe courses and/or weakened patients). As a supporting measure, a sufficient drinking quantity should be provided to balance the water and electrolyte balance.
In severe cases this can also be done by infusions. Apple pectin (e.g. Kaoprompt®) or loperamide (e.g. Imodium akut®, Loperamid-Ratiopharm®) can be taken to treat diarrhea.
In the case of an infection with Salmonella, therapy is mainly symptomatic. This means that treatment is not intended to cure the disease, but to reduce symptoms, so that the patient has a milder course and less discomfort until the disease subsides on its own.That can be accomplished with the Salmonellose therefore usually without hesitation, since it is normally harmless and there are in addition except antibiotics no effective medicines, which bring however even side effects with itself, which can be partly more serious than the actual illness and therefore usually not meaningfully to be used can. The main symptoms of salmonellosis (salmonella enteritis) are diarrhea and vomiting.
As a result, those affected can lose considerable amounts of fluid and electrolytes. For this reason, the most important part of a therapy for this disease is to balance the water and mineral balance. Patients are encouraged to drink plenty of fluids (many doctors recommend up to one glass of water per half hour!
), but caffeinated drinks such as cola or coffee should be avoided, as they tend to dehydrate the body even more. It is best to drink still water and tea, as these are the least stressful for the stomach. In order to prevent electrolyte deficiency, an affected person can take electrolyte solutions which are available in pharmacies.
In the worst case, both water and nutrients can be administered in the hospital using infusion solutions. Attention should also be paid to nutrition, inasmuch as patients often have a reduced appetite, but it is particularly important to supply the body with sufficient energy in order to successfully combat the disease. During the period of illness it is advisable to follow a diet that is as low in fat as possible so as not to place additional strain on the gastrointestinal tract.
Well-tolerated are for example: Further measures of a therapy concern the acute symptoms of salmonellosis. In cases of severe nausea, however, drops can be administered. If patients develop fever, this should also be treated with medication.
As long as the temperature does not exceed 39°C, the administration of paracetamol is recommended, as this is normally well tolerated by children. Although suppositories are otherwise frequently used in children, juices should be used for this disease, as they are more effective due to the diarrhea. Patients at increased risk are elderly people and infants and toddlers.
Due to their physique, they have fewer opportunities to compensate for fluid loss on their own and therefore have a more severe course of salmonellosis. Immunocompromised patients also react more strongly to the infection, as their immune system is not as well able to fight the pathogens on its own. For this reason, antibiotics are also used more frequently in the treatment of these high-risk groups.
The most commonly used antibiotics are either ampicillin, ciprofloxacin or cotrimoxazole. However, it must be noted that antibiotics prolong the elimination time of the pathogens with the stool, which is why an indication should always be checked carefully.
- Rusk
- Dry bread
- Potatoes
- Soups or bananas (which are also particularly cheap because of their high potassium content).
