Bacteremia, Salmonella

For further information, see CMDT Part 33-17: Salmonellosis

Key Features

• This complication tends to occur in immunocompromised persons, eg, HIV-infected individuals, who typically have bacteremia without an obvious source

Clinical Findings

• May be manifested by prolonged or recurrent fevers or by local infection in bone, joints, pleura, pericardium, lungs, or other sites

• Gastrointestinal symptoms not a prominent feature

• Mycotic abdominal aortic aneurysms may be a complication

Diagnosis

• Serotypes other than Salmonella typhi usually are isolated in culture of blood, bone marrow, or site of infection

Treatment

• Treatment is the same as for typhoid fever (see Enteric Fever [Typhoid fever]) plus drainage of any abscesses

• In HIV-infected patients, relapse is common, and lifelong suppressive therapy may be needed

• Ciprofloxacin, 500 mg twice daily orally, is effective both for treatment of acute infection and for suppression of recurrence

• Drug-resistant (fluoroquinolones and ceftriaxone) strains are increasing in prevalence