Bacteremia, Salmonella

Key Features

• This complication tends to occur in immunocompromised persons, eg, HIV-infected individuals, in older adults with preexisting aneurysms or atherosclerotic plaques

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 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

• Systemic antimicrobial therapy plus drainage of any abscesses is required; duration depends on the site of infection

• 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