Salmonellosis - symptoms in children, how and after how much they appear, the nature of the stool and the form of the disease. Salmonellosis in children is a deadly disease

salmonellosis is an infectious disease that is caused various types bacteria of the genus Salmonella, with more than 2200 serotypes. As a rule, salmonellosis is accompanied by damage to the organs of the gastrointestinal tract.

Sources of infection are domestic birds and animals, as well as a person sick with salmonellosis. Infection with salmonellosis is caused by eating foods containing a large number of salmonella, which occurs when they are insufficiently cooked. The incubation period for the food way of infection is 6-72 hours. contact-household transmission infections, the incubation period increases to 3-8 days.

Symptoms of salmonellosis

The main clinical forms of salmonellosis:

• gastrointestinal;
• generalized;
• acute, chronic and transient bacteriocarrier;
• subclinical form.

Symptoms of the gastrointestinal form of salmonellosis

The most common form of salmonellosis is gastrointestinal, characterized by the following symptoms:

• acute onset diseases,
• fever,
• chills,
• weakness,
• stomach ache,
• headache,
• nausea,
• vomit,
• stool disorder.

Some patients first develop fever and signs of poisoning, and then develop symptoms associated with gastrointestinal dysfunction. The duration and severity of symptoms of salmonellosis depend on the severity of the disease.

The mild form of salmonellosis is characterized by a single vomiting, a prolonged increase in body temperature up to 37-37.5 degrees, loose watery stools several times a day, lasting 1-3 days, fluid loss up to 3% of body weight.

With a moderate form of salmonellosis, symptoms such as:

• temperature rise to 38-39 degrees, up to 4 days;
• repeated vomiting;
• liquid stool several times a day, up to a week;
• tachycardia;
• pressure reduction;
• dehydration of 1-2 degrees is possible, with loss of fluid up to 6% of body weight.

The severe course of the gastrointestinal form is accompanied by the following symptoms of salmonellosis:

In addition, there is an increase in the spleen and liver, tachycardia, cyanosis of the skin, a significant decrease in pressure. On the part of the kidneys, albuminuria, oliguria, casts and erythrocytes in the urine, an increase in residual nitrogen are possible.

Possible development of acute kidney failure. Dehydration of 2-3 degrees, manifested in cyanosis, dry skin, convulsions and aphonia. Fluid loss by the body reaches 7-10% of body weight.

Symptoms of a generalized form of salmonellosis

The typhoid subtype of the generalized form of salmonellosis begins acutely. The first symptoms of salmonellosis are intestinal disorders, combined with general intoxication and high body temperature. After 1-2 days, intestinal dysfunction stops, the body temperature continues to be high, and the symptoms of intoxication become more intense.

Fever can be undulating or constant. Patients show lethargy, lethargy and pallor, some have a herpetic rash on the 2nd or 3rd day, and a roseolous rash on the abdomen from the 6th or 7th day.

In addition, relative bradycardia, decreased blood pressure, and muffled heart sounds may occur. Dispersed dry rales are heard. By the end of the 1st week of the course of the disease, an increase in the liver and spleen occurs. High body temperature lasts 1-3 weeks.

The most severe variant of the generalized form of salmonellosis - the septic form of the disease begins acutely and has a typhoid-like course in the first days. Then the condition of the patients worsens - there are significant fluctuations in body temperature, with chills and sweating.

The clinical symptoms of this variant of salmonellosis are diverse, and its diagnosis is difficult. Often, purulent foci are formed in the musculoskeletal system.

At times, septic endocarditis, aortitis with the formation of aortic aneurysm, tonsillitis, cholecysto-cholangitis, meningitis, cervical purulent lymphadenitis. Less common: infection of an ovarian cyst, liver abscess, mastoiditis, salmonella strumitis, abscess of the gluteal region.

Which doctors to contact with salmonellosis

Treatment of salmonellosis

Mild forms of salmonellosis do not require treatment and patients do not seek medical attention. In severe forms, gastric lavage should be done with warm water or a solution of baking soda. After washing, a laxative is used.

In case of intoxication, intravenous or subcutaneous injections of 1000-1500 ml of saline in half with 5% glucose solution are used. If vomiting does not stop, intravenously infuse hypertonic solution sodium chloride.

If necessary, assign cardiovascular agents. In a state of collapse, Polosukhin's anti-shock liquid is injected intravenously. In severe collapse, 500-1000 ml of polyglucin is administered intravenously.

To relieve intoxication in severe forms of salmonellosis, it is recommended to administer hemodez intravenously or drip. With chills and cramps, warm baths and heating pads are prescribed for the legs. In septic and typhoid forms, after vomiting stops, antibiotic treatment is used.

Drugs for salmonellosis

Diet after salmonellosis treatment

Nutrition after treatment for salmonellosis is practically the same as usual, except that about salmonellosis treatment at home, weeks should not be included in the diet of berries, raw fruits and vegetables, as well as dairy products. To restore the intestinal microflora, it is more advisable to take probiotics, rather than dairy products, which can cause flatulence and upset stools.

Pickles are also best avoided as they can lead to fermentation. During the rehabilitation period, it is desirable not to overload the gastrointestinal tract with heavy fatty and spicy food. Light soups, crackers and bagels, mashed potatoes, boiled meat are shown - this is the most “safe” food for a recovering gastrointestinal tract.

Prevention of salmonellosis

Prevention of salmonellosis consists in the following measures:

• sanitary and veterinary supervision of livestock slaughter;
• proper storage and transportation of meat;
• food storage at low temperature;
• reliable heat treatment of products;
• separate processing of raw and cooked products;
• isolation of patients and carriers of salmonella;
• compliance with the rules of personal hygiene.

Salmonellosis in children

Symptoms of salmonellosis in children

As a rule, in children older than 3 years, a gastrointestinal form of salmonellosis occurs, the course of which occurs according to the type food poisoning, and the duration incubation period ranges from several hours to 2-3 days.

The disease may be characterized by signs of gastroenteritis, gastritis or gastroenterocolitis. Salmonellosis in children older than 3 years is characterized by an acute onset of the disease and the occurrence of such symptoms as:

• nausea and vomiting,
• increase in body temperature up to 38-39 ° C,
• lack of appetite,
• stomach ache.

After a few hours, loose, watery and copious stools appear, sometimes mixed with blood and mucus. The frequency of diarrhea depends on the severity of salmonellosis. Then dehydration and severe toxicosis begin, convulsions are possible.

In children early age the contact-household route of infection prevails, but they also have the most common forms of the disease - gastroenterocolitis and gastroenteritis. Salmonellosis begins less acutely, with the maximum manifestation of all signs after 3-7 days.

Symptoms of salmonellosis in young children:

• heat,
• lethargy,
• pallor,
• slight cyanosis of the nasolabial triangle.

Vomiting may begin immediately, but may appear later, sometimes is persistent. Dehydration develops. The stool in children is liquid, fecal in nature, gradually acquires a dark green color, with an admixture of mucus, sometimes blood, of a large volume.

At infants salmonellosis manifests itself in moderate and severe forms, in addition to dehydration and intoxication, complications resulting from the ingress of salmonella into the blood are possible. In children with immunodeficiencies, there is a tendency to a protracted course of the disease with prolonged bacterial excretion.

First aid for salmonellosis in children

The first aid in case of food infection of children with salmonellosis is gastric lavage, which should remove a certain amount of bacteria and toxins from the child's body in order to alleviate the condition and remove intoxication.

Wash with 2% sodium bicarbonate or warm water. At easy course diseases without dehydration, gastric lavage can return the child to normal.

At home, gastric lavage can only be done for children over 3 years old: the child drinks a glass of liquid, after which he is pressed on the root of the tongue with a finger, causing vomiting. The procedure is repeated until the wash water is completely clean.

Diet for salmonellosis in children

The diet for salmonellosis in children should be extremely sparing of the intestines, therefore only boiled and pureed dishes and foods are used (diet No. 4). Whole milk and fats of animal origin are excluded from the diet, except for butter, vegetables rich in fiber.

Doctors advise giving the child rice and oatmeal on water and vegetable broth, meatballs, steam cutlets, boiled fish, fruit jelly, mild cheeses, cottage cheese.

The diet for salmonellosis is diversified gradually, and the usual diet is switched to with a complete clinical recovery, as a rule, 28-30 days after the onset of the disease.

Treatment of salmonellosis in children

Treatment of children with salmonellosis is individual and is prescribed by a pediatric infectious disease specialist. Most Salmonella species are resistant to antibiotics, so they are not usually used in treatment. The main emphasis is on diet, correction of dehydration and elimination of toxins.

With the development of common forms of salmonellosis, the treatment of children should take place in a hospital. In these cases, the use of antibiotics is mandatory, for which it is necessary to determine the susceptibility of Salmonella to antibiotics and choose the most effective of them.

The initial drugs of choice are levomycetin and ampicillin in age dosages. With prolonged bacteriocarrier, the main thing in the treatment of salmonellosis in children is the use of drugs to increase immunity.

Bacteriophages are used - drugs that destroy salmonella. Recovery intestinal microflora bifidumbacterin and bifikol are used, as well as sour-milk products with bifidobacteria.

Questions and answers on the topic "Salmonellosis"

Question:Hello, a 9-year-old child was treated with salmanulosis in the hospital, was discharged with diarrhea. The diarrhea continues to this day. How to stop it? Already 5 days at home

Answer: The child needs to be seen by a doctor.

Question:Pain in the leg after salmonellosis, what to do?

Answer: One of the consequences of the disease is arthritis, painful in the joints.

Question:Good afternoon The 3rd day is tormented by diarrhea and bloating. On the first day there was a temperature of 38.7 - we managed to bring it down. Now I feel fine in general, but the diarrhea does not go away. The stool is not green and seems to be without visible mucus. The attending physician eyeballed the diagnosis of salmonellosis and called an ambulance for my hospitalization, which I refused. Hope to get back on my own. I drink intetrix, bactisubtil, imodium, arbidol and mezim forte. Dear doctors, please tell me, will I live? Or listen to the doctor and run to the infectious diseases hospital? - I really don't want to.

Answer: Self-medication is always dangerous, but you will live. I think you will be all right. The survey won't turn up anything. If it doesn't go away, you need to see an infectious disease specialist. Continue treatment for 5 days. Further, only bactisubtil and dite (without black bread, legumes and whole milk). Wash fruits and vegetables thoroughly and heat-treat.

Question:My girlfriend (24 years old) has a son (1 year 8 months). At the end of September, the whole family was ill with salmonellosis, a friend and her son were in the hospital. The child had to be weaned there (literally in 3 days). A friend was treated with Norbaktin, took him after discharge, from 2 to 7 October. Around this time, conception occurred! A friend is determined to have an abortion, because she is afraid that salmonella and norbactin could adversely affect the fetus. In general, she wants a child, and I really want to help her collect as much information as possible about what are the chances of giving birth to a child without pathology in this situation. Thank you.

Answer: Past salmonellosis and taking norbactin during the expected period of conception is not an indication for termination of pregnancy. Pregnancy should proceed normally.

Question:Good afternoon She gave birth to a child at 36-37 weeks. I was discharged, and the child was transferred to the hospital. There are children without their mothers. They allowed me to come, breastfeed, but it was necessary to pass an analysis for intestinal group. On Monday I passed the test, and on Friday they said that they found salmonellosis in me. Weaned from the child, not allowed to bring expressed milk. On the same day I passed in three different places again this analysis. I went to the therapist, she prescribed to drink chloramphenicol 0.25 three times a day. I have no symptoms, the stool is normal. They said I could be a carrier. Tell me, could I infect a child? How many days after the last dose of chloramphenicol can I breastfeed?

Answer: You need to be patient and treat yourself and express milk regularly to keep milk production in your breasts. Of course, you could infect a child with salmonella. Therefore, everyone is recommended before conception and after a good examination of the body and, if necessary, treat the mother in advance. healthy mom - healthy baby. After the end of antibiotics, it is excreted from the body for another 8 hours. After 10 hours, it will not be in milk. If the infection is not treated, there may be an infection in the milk. Therefore, do not rush. But communicate with your child regularly.

Question:My child was diagnosed with salmonellosis (child 6 years old). A week before the results were ready, we were diagnosed with a rotavirus infection. The child had a temperature of 38-39 for 3 days, vomiting on the very first day of illness, loose stools. We drank smecta, arbidol and lineks. A week later, we went to the reception and they told us that the rotovirus infection was not confirmed, and that we had salmonellosis. But the child is doing well. There is an appetite, not lethargic. I asked the doctors to take a second stool test before starting to give the child antibiotics, but they assured me that there could be no mistake, and that we had 100% salmonellosis. Is it so that there is no mistake, and if the analysis is confirmed, then treatment should be started? But why then are there no signs of this disease at the moment?

Answer: If the doctors are confident in the correctness of the analysis, then you should not doubt it. Salmonellosis in older children often occurs in mild form without obvious symptoms. Be sure to listen to the opinion of doctors and go through the prescribed treatment.

Question:Please tell me: a child (9 years old) had salmonellosis. 2 weeks later SARS happened. I understand that while they were chasing salmonella, they weakened the intestinal flora. What should we do first? Restore intestinal flora? Or act differently?

The first measure really should be the restoration of the intestinal microflora. Then it will be possible to conduct a course of treatment with immunostimulating drugs.

Question:Hello! Does my daughter, she is 5.5 months old, have bloody stools? What does this mean? And how to treat? There was a temperature for 3 days, 38 and 2, the temperature was brought down. Thanks in advance.

Answer: Diarrhea with an admixture of blood is most often a sign of an intestinal infection (even salmonellosis is possible). We recommend that you take your child to the doctor as soon as possible.

Question:A 5-year-old child was diagnosed with salmonellosis. How many days do you need to take an antibiotic to fully recover? Is 7 days enough? And when can I take a control analysis?

Answer: It is usually recommended to continue a weekly course of antibiotic treatment for salmonellosis for up to 10 days. Fecal analysis should be taken immediately after the end of treatment, and then again after a few weeks.

Question:If a family member has been ill with salmonellosis - how long can he remain a carrier of the infection and what precautions should be taken?

Answer: Carrying and isolating a Salmonella infection can last from several weeks to several months. In order to reduce the risk of infecting others, the patient must undergo adequate treatment(antibiotics + enterosorbents + probiotics) under the supervision of a specialist and after the end of treatment, pass stool tests.

Salmonellosis is important due to its epidemic significance - there are usually whole outbreaks of the disease among children or adults. Microbes got their name thanks to their study by the scientist Salmon at the end of the 19th century, since then they have been studied in sufficient detail and methods of fighting infection have been developed, but to this day, salmonellosis has a high incidence, especially in summer period.

Causes of salmonellosis in children

salmonellosis- a classic food infection, but in addition to getting salmonella into the digestive tract, a number of special conditions are necessary - a massive amount of microbes, usually food contaminated with microbes, a decrease in the body's resistance at an early age or with diseases or allergies. Most often, salmonellosis is superimposed on existing health problems.

The causes of salmonellosis are special microbes, salmonella. Possessing special properties - they are gram-negative, mobile and small, resistant to many chemical and physical factors, tolerate freezing and drying well, can be preserved in room dust and linen, dried feces. For a long time, Salmonella survive in soil and water bodies, live well and multiply in meat and dairy products.

The place of primary infection and the introduction of salmonella is the area of ​​the small intestine, during the incubation period, the microbe multiplies and penetrates into the lymph nodes, and from there often into the bloodstream. In the area of ​​the mucous membranes of the intestine, erosions and ulcers occur, there may be swelling of the intestinal wall, its infiltration and hemorrhages, and zones of necrosis.

In very debilitated children and toddlers, salmonella can penetrate the internal organs and cause them to degenerative changes, inflammatory foci and abscesses. Besides, important role Salmonella endotoxin plays - it affects the autonomic nervous system with symptoms of intoxication, metabolic disorders and weight loss. After salmonellosis, immunity is unstable, so the disease can be transferred repeatedly in life.

Clinical manifestations of salmonellosis

Salmonellosis due to the fact that this is not the only disease, but a group of infections, may differ in clinical manifestations and severity. Food manifestations in the form of toxic infection and contact forms of salmonellosis are distinguished. A special type of salmonellosis are toxic-septic forms of the disease in newborns.

Food poisoning caused by salmonella. The incubation period for this type of infection ranges from several hours to three days from the moment the infected food arrives. Manifestations occur in the form of acute gastroenteritis or gastroenterocolitis. The body temperature rises sharply to 39-40 degrees, vomiting and abdominal pain appear, loose stools may join. Symptoms of intoxication appear with increased heart rate, decreased pressure, cyanosis and cold sweat, convulsions. There is a formation of abundant watery stools, there may be an admixture of mucus and blood. The abdomen is swollen and sharply painful. There may be symptoms of dehydration due to vomiting and diarrhea.

With a favorable course of the disease, the condition quickly improves, vomiting stops, and the general condition quickly returns to normal in the first week of the disease. The state of asthenia may persist for a long time with muffled heart tones and reduced pressure, but there may be cholera-like types of infection with a rapid development of the clinic.

These forms of the disease mainly occur in older children, although they can also occur in children at an early age.

Contract forms of salmonellosis are of several types, depending on their main clinical manifestations. Allocate a typhoid-like form, dysentery-like, dyspeptic, enteritis, septic, as well as asymptomatic and erased. In addition, there is a division of salmonellosis according to severity into mild, moderate and severe forms of the disease, while the main criterion for the severity of the condition is the degree of intoxication. Any forms, except asymptomatic, begin acutely, with fever and intestinal upset, with a predominance of symptoms of small intestine damage in the clinic.

The typhoid-like form manifests a pronounced fever with weakness and confusion, delirium, periods of fever alternate with periods of calm and last up to two weeks, which makes it look like typhus. From the onset of the disease, the stool becomes liquid and watery, with mucus, but occurs infrequently, up to three to five times a day, there may be bouts of vomiting, the tongue is lined and dry, thickened. The abdomen swells, rumbles and soreness on the right side is revealed, the liver may increase. The stool gradually returns to normal with a decrease in temperature.

Colitis forms of salmonellosis often occur in children of all ages, the manifestations are mostly local - frequent and loose stools appear, there may be mucus and blood, the temperature rises, vomiting and abdominal pain are not frequent, appetite may decrease, the tongue is lined and dry, the stomach is swollen , the liver reacts. The form is similar to manifestations of dysentery.

Dyspeptic forms are observed in babies up to a year old, mainly this is an increase in temperature to 38-38.5 degrees against the background of bloating, diarrhea and vomiting, while the stool is plentiful with food particles, there may be a little mucus. Often in children for a long time there is a liquefaction of the stool and a bacteriocarrier. The equivalent of this form in children older than a year is the enteric form.

Septic forms of salmonellosis is one of the most complex and serious. They are rare, but can be fatal. Often this form affects newborns and children at an early age.

The temperature rises to 40 degrees and above, symptoms of damage to the brain and its membranes may appear with the phenomena of meningism, a violation of the composition of the cerebrospinal fluid and the sowing of salmonella from it. At the same time, there are manifestations bowels - diarrhea and vomiting. But they are not as pronounced as general lesions. The stool is loose and poorly digested, with blood and mucus.

Why is salmonellosis dangerous?

In addition to its already severe course, salmonellosis is dangerous by the formation of local foci of inflammation in the internal organs due to the spread of salmonella from the intestine throughout the body. In addition, salmonellosis dramatically undermines the body's defenses. Causing immunodeficiency and forming a layer of secondary infection or exacerbation of chronic diseases. Often, transferred salmonellosis leaves behind a trail of persistent otitis media, tonsillitis and pneumonia.

In addition, a child can become a carrier for a long time, and this will lead to a ban on visiting public places and children's groups (especially kindergartens and schools).

Methods for diagnosing salmonellosis

Initially, an acute intestinal infection is diagnosed with suspicion of one or another pathogen, but the final diagnosis can only be made by bacteriological cultures of blood, feces, and sometimes urine.

It is necessary to isolate the pathogen from biological fluids, determine its type and examine and examine all contacts. This quarantine infection, which requires the implementation of all serious measures by the forces of the SEC.

In order to determine the treatment, it is necessary to inoculate pathogens on nutrient media with the determination of the sensitivity of microbes to antibiotics and phages.

Treatment of salmonellosis in children

Salmonellosis is treated by infectious disease doctors in an infectious diseases hospital. At the same time, it is carried out complex treatment, sometimes in the first days on the basis of intensive care and resuscitation wards. The basis of treatment includes adherence to bed rest, dietary restrictions and therapies aimed at eliminating the pathogen and the changes that are caused by it. Therapy will be based on the age, severity of the child and the presence of concomitant pathology.

Children under three years of age with an intestinal infection clinic, as well as children from organized groups according to epidemic indications, are subject to mandatory hospitalization.

The basis of the diet for salmonellosis are all the same general principles as in other intestinal infections. In the acute period, additional drinking and nutrition with sour-milk mixtures and products that do not irritate digestion are necessary - cereals, vegetable purees, light soups, according to appetite. Gradually, nutrition expands, but spicy, fried and spicy dishes, food that irritates digestion, are subject to long-term exclusion. It is important to fortify food and make it varied.

The basis of the treatment of salmonellosis- this is the appointment of drugs that kill salmonella - antibiotics and intestinal antiseptics. These drugs are prescribed in the acute period of infection in severe and moderate forms, with mild forms, it is possible to prescribe intestinal antiseptics. The choice of antibiotic is initially carried out from the group of widely used, then adjusted according to the results of culture and sensitivity to antibiotics. This is usually a group of cephalosporins used parenterally, especially for frequent vomiting. In mild forms, antibiotics are prescribed by mouth in age dosages.

In older children or in carriers without manifestations of the disease, specific anti-Salmonella bacteriophages, immune lactoglobulins and biological preparations for the correction of microbial flora are prescribed to destroy Salmonella.

With toxicosis and severe dehydration, an intravenous infusion of glucose solutions and saline preparations is indicated, if the child can drink and vomiting is infrequent, it is shown to solder it with these solutions through the mouth. It is necessary to ensure that the amount of fluid excreted with vomiting and diarrhea is completely replenished.

With severe diarrhea, antidiarrheal drugs are prescribed, but only on the recommendation of a doctor, since toxins with microbes also come out with diarrheal masses. If necessary, enzyme preparations, probiotics and complexes of beneficial bacteria for the intestines are prescribed. With a protracted course and chronic, immunotherapy and phages are used.

Surveillance of recovered patients and contacts

Children who have recovered from salmonellosis stand on dispensary observation from a doctor with a monthly determination of Salmonella carriage by bakposev. Every month they are examined by an infectious disease specialist with an analysis. In case of negative tests, children are removed from the register.

For children and adults. The patients who were in contact are observed for seven days, examining their fecal analyzes bacteriologically. If they are negative, they are considered healthy. Recovered from salmonellosis children with negative test results can visit children's institutions without restrictions.

In the focus of salmonellosis, food and water are examined, since food products become the main source of infection. It is also necessary strict observance rules of personal hygiene and technology of preparation and storage of food. In the focus of infection, current disinfection is carried out, as well as the final one after everyone has been ill.

Forecasts for salmonellosis are favorable, almost all children recover from it without consequences. Dangerous salmonellosis can be for infants and children with weakened immune systems, often sick and having chronic pathologies. Therefore, for such children, the issue of nutrition becomes especially important, especially in the summer. It is always necessary to strictly monitor the quality of food and its shelf life, cooking methods - especially for meat and confectionery products.

• The main causes of infection
• Diagnostic methods
• Treatment
• Prevention

Almost every second child spends the lion's share of his free time on the street. Here he plays with stray animals and other people's toys, eats food shared with him by friends with dirty hands, and does many other things that are harmful to his fragile immunity.

Therefore, it is not surprising that salmonellosis is much more common in children than in adults, and knowing how to deal with this infection is the responsibility of every good parent.

The main causes of infection

The first thing that needs to be clarified before talking about how to cure salmonellosis in a child is the causes of the disease. This knowledge will not only help protect the baby from re-infection, but also help in its treatment.

The source of infection are:

1. Food products, the process of storage and / or heat treatment of which has been violated.
2. Houseware. For example, dirty toys or things.
3. Contacts with raw water. Equally dangerous is its consumption inside and bathing in untested reservoirs.
4. Livestock and wild animals in which the carriage of salmonellosis is not even accompanied by the disease itself.

Some parents, paying too much attention to the child, forget that they themselves can become a carrier of infection. A vivid example of this is newborns, who often come into contact with the pathogen transplacentally (that is, while still in the womb).

In the first months of life, babies have no contact with almost any of what is described above. However, since infants' immunity is still rather weak, salmonellosis can provoke even the slightest contact with an infected person, whose illness can also occur in an asymptomatic form.

Good to know. Salmonella is an extremely hardy bacterium. So, once in the soil, it remains active for up to 1.5 years, and in raw water - up to 5 months. In cheeses, she "lives" up to a year, in milk - no more than a month, in kefir - up to two months, and in butter- up to four. As for meat and sausage products, here the average value is 2-4 months, for frozen meat - half a year, for poultry - more than a year.

Types of salmonellosis and their symptoms

Having learned how salmonellosis is transmitted, you can go directly to its symptoms. The disease can proceed in different ways, so it is customary to distinguish three forms of its manifestation.

1. Gastrointestinal (localized) form

In children, this type of salmonellosis is most common. Its severity directly depends on the scale of intoxication and water and electrolyte losses (dehydration).

Common symptoms include a sharp rise in temperature to at least 37.5 ° C, mild fever, chills, headaches and body aches, and “brokenness” of the body as a whole.

This form corresponds to 3 varieties of the disease, differing in the severity of their course:

Gastroenteric salmonellosis

It appears after a couple of hours from the moment of infection and proceeds quite sharply. In addition to the above symptoms, the patient also has:

• spastic pains in the abdomen (in the area of ​​the epigastric and umbilical regions);
• repeated nausea and vomiting;
• diarrhea, during which the feces acquire a greenish tint and a watery, frothy texture.

The temperature in this form rises quickly, but not significantly. Almost immediately, the patient develops bloating, accompanied by rumbling in the intestines. In especially acute cases, cyanosis (cyanosis of the skin and / or mucous membranes) and the occurrence of clonic convulsions in the region of the lower extremities are observed.

Gastroenterocolitic salmonellosis

On initial stage this type of disease proceeds in exactly the same way as the previous one. Differences appear approximately 2-3 days after infection.

The child has a significant reduction in the volume of bowel movements, and in feces mucus (sometimes blood) appears. The very act of defecation is increasingly accompanied by tenesmus (painful false urges). On palpation, a spasm of the large intestine and its general painful condition are clearly felt.

Often, gastroenterocolitic salmonellosis is confused with dysentery, which occurs in an acute form.

Gastritis salmonellosis

It is difficult to say exactly how much this form is being treated (because the nature of the course of the disease manifests itself individually), while listing its characteristic features is much easier. These include:

• no diarrhea;
• abrupt and acute onset of the process;
• insignificance of intoxication;
• pain localized in the epigastric region;
• recurring vomiting.

This type of salmonellosis in children is rare, but they fight it mostly successfully.

2. Generalized form

In many cases, the flow of the disease into this form is facilitated by insufficiently effective treatment of salmonellosis in children in the gastroenteric stage. It takes quite a long time and is problematic.

The main feature of the generalized form is the occurrence of purulent foci in the lungs (which contributes to the development of pleurisy and pneumonia), heart (the first step to endocarditis), kidneys (which subsequently affect pyelitis or cystitis) and muscles (where phlegmon and abscesses are threatened).

It is divided into 2 varieties:

Typhoid-like salmonellosis

This type of disease can occur without the symptoms characteristic of gastroenteritis. In other words, symptoms such as nausea, vomiting and diarrhea appear only for the first few days, and then completely disappear.

At the same time, the child is noted:

• undulating temperature drops;
• regular headaches;
• interruptions in sleep and, as a result, lethargy and weakness;
• hepatolienal syndrome (enlargement of the spleen and liver);
• general intoxication of the body and the manifestation of a hemorrhagic rash.

The complexity of treatment is due to the difficulties of diagnosis. The clinical picture is largely similar to the course typhoid fever, and therefore the risk of prescribing the wrong treatment is high. Only additional diagnostics can help in this situation, which often takes time, which the child no longer has.

Septic salmonellosis

It is characteristic mainly for infants and newborns. At the initial stage, symptoms characteristic of gastroenteritis are clearly visible, which are replaced by remitting fever (temperature changes that constantly fluctuate between 1-2.5 degrees).

Also, the baby has tachycardia, sweating increases, myalgia begins (muscle pain associated with the fact that the cells are constantly in good shape). There are cases when hepatosplenomegaly is diagnosed (a one-time, significant increase in the liver and spleen).

3. Bacterial excretory form

This form of the disease is remarkable in that during its course, the patient has no clinical symptoms. It is detected only by diagnostics and is divided into:

• acute

Isolation of salmonella in convalescents (recovered children) lasts 15-90 days.

• Transient

Isolation of Salmonella is present, however, at the time of the examination, and for 3 months before it, it was noted no more than 1-2 times. And serological tests also showed a negative result.

• Chronic

Carrier status is confirmed for more than 3 months.

Features of symptoms in newborns

In children under one year old, the symptoms of salmonellosis manifest themselves somewhat differently than in the rest. Here, the signs of intoxication come to the fore:

• excessive anxiety and sleep disturbance;
• frequent regurgitation and bloating;
• dehydration and causeless cooling of the limbs;
• hypotrophy and retraction of the fontanel.

At the same time, the baby's body temperature can remain within the normal range for up to several days (although sometimes it rises to 39 ° C almost immediately).

Vomiting, diarrhea and the rest of the symptoms described above also do not immediately make themselves felt. Diarrhea manifests itself in all its glory for 3-4 days from the moment of infection. The stools are watery and greenish in color. On the seventh day, blood streaks are found in the feces. Left untreated at this stage, it is predominantly fatal.

Good to know. The incubation period of the disease in newborns ranges from a couple of hours to 2-4 days. Therefore, so that the child does not later suffer from complications, it is worth showing it to the doctor at the slightest suspicion of infection.

Diagnostic methods

In a number of ways, salmonellosis is similar to a number of other acute intestinal infections. Therefore, the first thing to do in order for the treatment to be effective is to make sure the accuracy of the proposed diagnosis. After all, while you do not know, but only assume what your child is sick with. The main assistant in this matter is the diagnostics prescribed by the attending physician at the first appointment.

Depending on the type of disease, as well as on the stage of its course, one can distinguish different types how children are tested for salmonellosis:

• Bacterial culture of feces and vomit

If there are suspicions that the disease has passed into a generalized form, urine, bile, washings of the stomach and intestines are also used. Among the strengths of the analysis is its high sensitivity. It allows not only to identify infectious agents, but also to assess their number, activity and resistance to various antibiotics. The main disadvantage of the method is its duration (up to 10 days), while any delay can cause irreversible complications in the child's body.

• Express Diagnostics

Immunofluorescence kits and latex agglutination kits are commercially available today. And therefore, having found signs of salmonellosis in a child, before going to the doctor, you can independently check it for the reliability of the diagnosis. In the medical environment for express diagnostics, a test for ELISA, RIA, RKA, RLA is used.

• Serological blood test for the presence of antibodies

This study is carried out when it is already known for sure that the child is infected in order to determine the success of the prescribed course of treatment. For the first time, blood sampling is performed a week after the diagnosis of salmonellosis and 10 days later. The procedure is repeated at the end inpatient treatment. Doctors are interested in an increase in antibody titer, minimal diagnostic value which is 1:200.

Depending on the type of disease and the stage of its course, tests are prescribed for children on an individual basis. However, if all the symptoms of an epidemiological outbreak of salmonellosis are present, in addition to them, a bacteriological analysis of the remains of contaminated food and washings from the dishes in which it was located is also carried out.

Good to know. More often than others, children under the age of 2 years are susceptible to salmonellosis, and the bulk of outbreaks of the disease occur in the summer-autumn season.

Treatment

Now that we know both how salmonellosis manifests itself and how it is diagnosed, it's time to talk about treatment. If in adults it (in the vast majority of cases) does not require specific actions and is limited only to taking drugs, then in the case of children, such a number will not work.

So, the treatment of infants should be carried out strictly within the framework of hospitalization. Otherwise, without timely medical care, the baby risks developing cerebral edema and dying.

Medical therapy

By nature, salmonella is a bacteria. Therefore, it would be logical to assume that it should be treated with various antibacterial drugs, is not it?

Arguing in this way, you risk not only not curing your child, but also causing much more significant harm to him. The fact is that the symptoms of salmonellosis, typhoid fever and a number of other infections are very similar. And medicines for salmonellosis for children are quite different from the same remedies for dysentery.

Even doctors will be able to unequivocally determine what kind of ailment struck your crumbs only after a thorough diagnosis. And improperly prescribed treatment will only provoke an exacerbation.

Remember, only a doctor can prescribe antibiotics for salmonellosis! You only need to deliver the baby to the pediatrician as quickly as possible or call him at home.

Independent measures in the fight against the disease

As already mentioned, the causative agent of salmonellosis is extremely specific and is characterized by increased resistance to cold and a number of antibiotics. Therefore, even drugs such as Enterofuril cannot always help. However, this does not mean at all that you need to be inactive until the doctor arrives.

In some cases, the infection manifests itself in just a couple of hours, and rapid dehydration of the body can cause irreparable harm to the child. As we have already found out, we cannot stuff him with antibiotics, however, it is quite possible to alleviate the condition of the baby by preventing his dehydration.

This can be done either with the help of specialized oral rehydration powders, which can be easily found in every pharmacy, or using the following recipe:

• in clean still water (1 l), dissolve baking soda (1 tsp), then sugar (2 tsp), and then salt (1 tsp). Received saline solution mix thoroughly and solder the child to them until the ambulance arrives.

This drink does not taste very pleasant, so if your baby flatly refuses to drink it, offer him any other drink, be it water, tea or compote. From liquids containing various dyes and chemicals (from the same soda) should be.

If it is not possible to give a child a drink in the traditional way, for example, if dehydration has overcome a monthly baby, an ordinary syringe will come to the rescue (naturally, without a needle!). Fill it with the solution described above and, before the ambulance arrives, carefully pour it into the corner of the baby's mouth. Be sure to keep your head down so it doesn't choke.

Nuances of nutrition during and after treatment

What can a child eat with salmonellosis? This issue is no less important than the others discussed in this article. Proper nutrition correction contributes not only to speedy recovery, but also the restoration of undermined immunity.

The optimal product for children in their first year of life has been and remains unpasteurized breast milk. It not only easily fills the need of a weakened body for trace elements and vitamins, but also provides it with proteins, carbohydrates, fats and a number of protective, biologically active substances.

If the age of the little one has already exceeded the mark of 4 months, and he himself feeds by artificial feeding, then for the first 1-2 weeks his menu includes:

• fermented milk mixtures;
• 10% rice and/or buckwheat porridge, brewed in water;
• vegetable puree.

In the future, the doctor analyzes the combined results of treatment and diet, after which he makes a verdict on how effective the diet is and adjusts the course (as a rule, in the direction of expanding the range of dishes allowed for consumption).

The diet of older children who fell ill just the other day is carefully mashed, easily digestible food that has undergone mandatory heat treatment. These can be soups, and diverse vegetable dishes, and boiled rice, etc. It is allowed to include meat and fish in the menu, but only on condition that they were steamed.

The following fall under the ban:

• fermented milk products that enhance peristalsis (wave-like contraction of the walls) of the intestine;
• flour products made from rye;
• any sweets and pickles;
• vegetables and fruits served raw;
• berries and various spices.

The duration of the course is 27-30 days from the date of diagnosis of the disease. However, depending on the complexity of its course to restore the child's strength, nutritional adjustments can continue after his recovery.

Since the disease is quite specific, the diet after salmonellosis is prescribed individually by the attending doctor. However, in general terms:

• exclusion from the diet certain period subject to: dairy products, fatty and spicy foods, fresh fruits and vegetables, sweets, some types of legumes, cabbage and juices;
• the basis of the menu for this time should be: dairy-free cereals, soups with meat, but not cooked on meat broth(i.e. the meat is cooked separately and then added to the already prepared soup), lean poultry and meat soufflés, baked fruits (for example, baked apples or bananas).

If, among other things, the child suffers food allergies, fermentopathy or dysbacteriosis, his diet for salmonellosis should be adjusted for these diseases. All foods with a high content of allergens are added to the list of prohibited foods, and the list of must-have dishes is supplemented various decoctions, vitamins and other agents used in phage and immunotherapy.

Good to know. Formerly popular "water-tea", starvation diet today recognized as ineffective. However, in the first five days, doctors advise reducing food intake by 5-15%.

Consequences and threats to the health of the child

Why is salmonellosis dangerous in children? It is this question that first arises in parents whose baby is faced with this disease. As a rule, if the appeal to the doctor was timely, the disease does not cause any complications. However, if a baby had a chance to encounter it, whose immunity is not strong enough (for example, a baby), or the treatment was not prompt enough, the consequences can be serious.

We have already mentioned that the course of the disease is accompanied by vomiting, diarrhea and other unpleasant symptoms. However, even after recovery, the child faces a number of complications.

1. Prolonged dehydration leads to interruptions in the functioning of the renal channels (renal failure) and contributes to the accumulation of nitrogenous waste in the patient's blood.
2. Bacterial excretion lasting over 3 months after recovery - clear sign the fact that the disease had too strong an effect on the body, and the child now needs treatment for chronic salmonellosis.
3. Prolonged intoxication negatively affects the work of the cardiovascular system. In especially advanced cases, it causes cerebral edema.
4. The consequences of salmonellosis can also be expressed in inflammation of various internal organs because salmonella spreads throughout the body through the bloodstream.
5. In young patients suffering from chronic diseases, relapses provoked by immunodeficiency are not uncommon.

However, do not forget that in addition to them, the disease also has social consequences.

For example, if there is a suspicion that a child is a carrier of bacteria, the entrance to public places is closed for him. And if in the case of an amusement park or a swimming pool this will not be much of a problem, then a ban on attending a school or kindergarten can serve as a reason for lagging behind the program and biased attitude.

Prevention

Everyone knows that avoiding the disease is much better than dealing with all sorts of its consequences. It is not difficult to prevent the first entry of salmonella into the body or the recurrence of salmonellosis.

For many, especially young and always busy parents, the question is different, are you ready to give your child enough time to protect him from this and a number of others. unpleasant diseases? After all, then you have to:

• Regularly organize wet cleaning in the house and clean not only the rooms themselves, but also the children's toys in them.
• Refuse to visit prohibited water bodies and places with a high content of dust.
• Carefully iron not only the things of the baby, but also your clothes with which he can come into contact.
• Until the baby realizes the importance and significance of personal hygiene, do not let him out of sight. And also to control everything that he pulls into his mouth.
• Minimize contact of the child with farm and wild animals (goats, pigeons, pigs and other potential carriers of Salmonella).
• Store products of animal origin separately from the rest and feed them to children only after thorough heat treatment.
• Refuse fast food and snacks that are harmful to the young body and for a number of other reasons.
• Cut meat on a separate board and wash your hands thoroughly before touching other ingredients of the dish at the end of cutting.
• Purchase products only from certified outlets. Store eggs for no more than 20 days, and homemade mayonnaise for no more than a day and in a tightly closed container.
• Teach the little one to hygiene from an early age and follow its rules yourself. Wash your hands not only exclusively before eating, but also at the end of the meal, after a walk, clean not only clothes, but also toys, do not pick up food from the floor, etc.

It must be understood that salmonellosis in a child can manifest itself even if all of the above rules are observed. Prevention only reduces the likelihood of the disease, and is not a panacea for it. However, sticking to it is much better than fighting the disease for a long time, and then also improving the work of the body depleted by it after recovery.

Do you have any questions? Want to learn more about how to treat salmonellosis in children? Leave comments, let's discuss.

Salmonellosis in children is a disease digestive system, the development of which is associated with infection of the body with Salmonella bacteria. The pathology is acute with severe intoxication and dehydration. Cases of contacting a doctor with salmonellosis become more frequent in the warm months of the year. They are explained by eating foods with expired validity. The most sensitive patients are children under 2 years of age.

Why does salmonellosis develop?

For the development of salmonellosis in the body, there must be certain conditions. These are:

• the child's tendency to allergies;
• frequent morbidity;
• weak immunity at an early age;
• damage to the gastrointestinal tract by microbes that came with poor-quality food.

The causes of diseases are salmonella - gram-negative mobile microbes that are resistant to various physico-chemical factors. The strains tolerate frost and drought well, persist in dust and feces. They exist for a long time in the soil and water bodies and take root in meat and dairy products.

Animals, waterfowl and sick people become sources of infection for a child. The pathogen is transmitted in several ways.

1. Air-dust - by inhalation of contaminated dust.
2. Food, if the baby consumes milk, meat or eggs without proper heat treatment or raw water.
3. Contact household. This type of infection often develops in infants when parents or medical staff care for them with unwashed hands. Germs can be found on pacifiers, toys, and other accessories.
4. Transplacental. Infection of the child occurs in utero if the pregnant woman is sick with salmonellosis.

Clinical features of salmonellosis

Symptoms of salmonellosis in children do not immediately become pronounced. Many factors influence the incubation period, therefore, parents can notice a significant deterioration in the health of the baby only after 3 days from the moment of infection. What signs the disease will manifest depends on the general condition of the child, his age and the stage of salmonellosis.

• Newborns. In the first month of life, there is no clear evidence of gastrointestinal damage, temperature indicators remain normal. Mothers note the refusal of the baby to eat and the lack of weight. Skin turn pale, the tummy swells, belching comes out of the mouth. The baby is constantly worried.
• Babies. TO early symptoms salmonellosis infections in children under one year old include vomiting and increased stools up to 7 p. per day, poor appetite and a jump in temperature to high levels. If left untreated, diarrhea worsens and causes dehydration.
• Preschoolers and older children. Salmonellosis develops rapidly with sharp rise body temperature (38 - 38.5 ° C), abdominal pain, repeated vomiting and diarrhea. Children complain of decreased appetite and general weakness. Delayed or inadequate therapy leads to dehydration, acute renal failure and toxic shock.

The famous pediatrician Komarovsky draws the attention of parents to the external manifestations of salmonellosis. The condition of children deteriorates sharply, the body reacts to microbes with severe intoxication. If you suspect that the baby has become a victim of salmonella, urgently go to the clinic or call an ambulance.

Methods for diagnosing salmonellosis

The primary diagnosis after a general examination is an acute intestinal infection. The final verdict is made by the infectious disease specialist or gastroenterologist based on the results of blood and urine tests and bacteriological culture of feces. To tasks diagnostic measures includes the isolation of the pathogen with the definition of its type and the examination of all persons in contact with the child.

Misdiagnosis and the neglected state of the child give enough serious complications:

1. reactive arthritis;
2. convulsive syndrome;
3. kidney failure;
4. infectious-toxic shock;
5. swelling of the lungs or brain.

How to treat children with salmonellosis

Drug treatment of salmonellosis in children is prescribed strictly individually and without the involvement of folk methods. With a disease of moderate and high severity, the patient is placed in a hospital. In mild forms of salmonellosis, therapy is carried out at home.

With food contamination, treatment begins with gastric lavage. Sodium bicarbonate solution contributes to the partial elimination of toxins from the body and the elimination of intoxication. A 2% concentrate of the substance is diluted with 2-3 liters of water at a temperature of 18-20°C. Hemosorption, or blood purification, is carried out using the drugs Sorbilact, Reosorbilact, Reopoliglyukin.

The state of dehydration is eliminated by the use of rehydration solutions:

• Oralite;
• Regidron;
• Glucosolan.

The child is drunk with solutions at the rate of 40 - 70 ml of the product for each kilogram of body weight. With severe intoxication without dehydration, the dose is reduced to 30-40 ml.

The use of antibiotics for the treatment of children from salmonellosis is resorted to only in severe cases. First determine the sensitivity of the detected Salmonella. Based on the data obtained, a suitable drug is selected. Usually this is a group of cephalosporins that stop repeated vomiting. Of the intestinal antiseptics, small patients are prescribed Enterofuril or Ersefuril.

Carriers of salmonella and older children are prescribed:

1. probiotics;
2. immune lactoglobulins;
3. bacteriophages are specific anti-salmonella agents.

With salmonellosis, baby food should be sparing, protecting the intestinal mucosa from strong mechanical and chemical exposure. Complete exclusion from the diet are subject to:

• whole milk;
• coarse fiber vegetables;
• animal fats;
• marinades, spices, smoked meats, seasonings.

Useful for a child affected by salmonella will be:

• cottage cheese;
• low-fat cheese;
• boiled fish;
• fruit jelly;
• steam cutlets and meatballs;
• oatmeal and rice porridge on water and vegetable broths.

The dietary diet must be followed for 4 weeks from the onset of the disease.

Our expert comments

1. Remember that the consequences of salmonellosis undermine immune system, involving secondary infection or exacerbation of chronic pathologies. Salmonella remaining in the intestines spread throughout the body and form local foci of inflammation. A sick child can subsequently suffer from angina, otitis or pneumonia for a long time.
2. Observe the rules of personal hygiene and do not violate the technology of cooking. High-temperature processing of animal products. Do not give your child raw eggs, and wash the shell thoroughly before preparing omelettes and scrambled eggs.
3. To prevent salmonellosis infection, store meat in the freezer. Get a separate board for cutting game and chickens.

With a timely visit to the doctor, the prognosis for the treatment of salmonellosis is favorable. Therapy takes place in 5 - 10 days, but immunity against salmonella is not developed. Therefore, the child can get sick again.

Doctor talks about the danger of salmonellosis for a child

Salmonellosis in children is an acute infectious disease of the digestive system that occurs as a result of infection with Salmonella bacteria. The disease is accompanied by dehydration and severe intoxication, sometimes occurs with septicemia (in infants) or typhoid (in older children).

Salmonellosis develops in the form of isolated cases or outbreaks. Most often, cases of salmonellosis are recorded in the summer due to frequent violations of food storage conditions. Read more about what salmonellosis is, what are its causes, how to treat it and how to cure it, read our article.

Causes of the disease and ways of transmission of the pathogen

The causative agent of the disease - salmonella, affects not only people, but also animals. It is stable in the external environment, tolerates low temperatures and the action of many antibacterial drugs, but quickly dies when boiled and the use of disinfectants. Salmonella actively multiply in animal products - milk, meat, butter, eggs.

The source of infection for a child is mainly animals, less often infection occurs from a sick person. greatest danger represent waterfowl.

The main ways of transmission of the pathogen:

1. Food - when eating dishes from eggs, milk, meat, which are not thermally processed immediately before use (soufflé, cakes, salads). There is also a risk of infection when drinking unboiled contaminated water.
2. Contact-household - the main route of transmission of salmonellosis in infancy. A child can become infected through the dirty hands of parents or medical personnel, changing tables, care items, nipples, toys, towels.
3. By inhalation of contaminated dust.
4. Transplacental - the pathogen is transmitted in utero from mother to child.

Children under 2 years of age are most susceptible to salmonellosis.

The place of initial localization of salmonella is the small intestine. During the incubation period, the bacterium multiplies and spreads to the lymph nodes and bloodstream.

Types and forms of the disease

Depending on the clinical picture and localization of the pathogen, salmonellosis is divided into:

1. Gastrointestinal:

• gastric;
• gastroenterocolitic;
• gastroenteric.

1. Generalized:

• typhoid;
• septic.

1. Bacterioexcretion:

• acute;
• transient;
• chronic.

Symptoms of the disease in children

The incubation period for salmonellosis ranges from several hours to 5 days. Symptoms vary depending on clinical form illness. The main signs of any form of salmonellosis are:

• acute onset with fever (lasting from 5-7 days to 2-3 weeks);
• frequent fetid stools (normalizes after 7-10 days);
• signs of dehydration (dry mucous membranes and skin).

Features of the clinical picture in infants and newborns

In young children, symptoms of general intoxication predominate over the symptoms of intestinal disorders.

Body temperature may remain normal. Hypotrophy is observed in children, they do not gain weight well.

Babies are restless, often spit up, the stomach is swollen, the extremities are cold.

Dehydration is manifested by dry skin, mucous membranes, tongue, oliguria, retraction of the fontanel.

Gastrointestinal form

Most common among children. In children older than 2 years, it occurs in the form of gastritis or gastroenteritis. Symptoms:

• epigastric pain;
• heat;
• general malaise, weakness;
• frequent vomiting;
• frequent profuse diarrhea with particles of undigested food;
• tongue dry, coated with thick coating;
• slight flatulence.

The gastrointestinal form in infants occurs in the form of enteritis. Signs:

• stomach ache;
• episodic vomiting, nausea;
• diarrhea up to 5 - 10 times a day; stools are mushy or liquid, continuous, with an admixture of mucus, greenery, white lumps with a sharp sour smell;
• bloating and rumbling in the abdomen;
• subfebrile body temperature.

The colitis form in children is rarely fixed and has clinical picture colitis. Main features:

• acute onset with symptoms of intoxication;
• pain in the large intestine;
• liquid green stools streaked with blood and mucus.

typhoid form

Characteristic signs:

• dyspeptic symptoms (diarrhea, vomiting, flatulence);
• persistent or fluctuating fever;
• symptoms of general intoxication (malaise, headache, weakness);
• hemorrhagic rash on the skin;
• hepatosplenomegaly.

septic form

More common in newborns and infants. Symptoms:

• dyspeptic phenomena;
• fever with severe chills and profuse sweating;
• hepatolienal syndrome;
• tachycardia.

After salmonellosis, some children continue to release the pathogen into the environment for a month. If bacterial excretion lasts more than 3 months, it is considered chronic.

The danger of salmonellosis in childhood

The disease can have serious complications with high probability death:

1. infectious-toxic shock;
2. cerebral edema;
3. pulmonary edema;
4. kidney failure;
5. convulsive syndrome;
6. reactive arthritis;
7. purulent complications.

Diagnosis of salmonellosis

When the first signs of salmonellosis are detected, parents should contact an infectious disease specialist or gastroenterologist to confirm the diagnosis. The doctor uses the following examination methods:

• inspection;
• bacteriological culture of vomit, feces, intestinal and stomach washings;
• analysis of feces for dysbacteriosis;
• coprogram;
• general blood analysis;
• RNGA of blood - detection of antibodies to salmonella.

Treatment of salmonellosis in children

Therapy for a mild form of salmonellosis is carried out at home. Children with a severe course of the disease and infants are subject to hospitalization.

Treatment of the disease includes diet therapy, measures aimed at correcting dehydration and cleansing the body of toxins.

The child's nutrition should consist of mashed and boiled foods (diet No. 4). Exclude from the diet:

• animal fats;
• whole milk;
• vegetables with coarse fiber.

The baby can be fed:

• oatmeal or rice porridge in water or vegetable broth;
• boiled fish;
• steam cutlets, meatballs;
• fruit jelly;
• cottage cheese, low-fat cheeses.

The diet continues 28 - 30 days from the onset of the disease.

Removal of toxins from the body

In order to cleanse the body, apply:

1. Gastric lavage with water or sodium bicarbonate solution.
2. Hemosorption with drugs Rheosorbilact, Sorbilact, Reopoliglyukin. The drugs are administered intravenously-drip after correction of dehydration.

Dehydration Correction

1. Regidron, Glucosolan, Oralit are administered orally at the rate of 40-70 ml per 1 kg of body weight per day (depending on the degree of dehydration). The solution is given in fractional portions (1 tsp every 5 minutes) during the day.
2. Intravenous administration of glucose solution, physiological saline - if oral rehydration is not possible.

With a generalized form, antibiotics are additionally prescribed - Levomycetin, Doxycycline.

With the gastrointestinal form, children are shown taking enzymes - Enzistal, Festal.

With prolonged bacterial carriage, the following is prescribed:

1. means to increase immunity;
2. bacteriophages;
3. probiotics - Bifikol, Bifidumbacterin.

Treatment prognosis

With timely treatment to the doctor, the prognosis for recovery is favorable. Most children tolerate salmonellosis without consequences or complications. A dangerous disease can be infants and weakened children.

How to prevent salmonellosis

Measures to prevent salmonellosis:

1. Eat only well-thermally processed foods (meat, eggs).
2. If there is a patient with salmonellosis at home, provide him with individual hygiene and tableware.
3. During wet cleaning, it is also necessary to wash children's toys.
4. Make sure that the baby does not take various objects from the floor into his mouth.
5. Do not swim in prohibited waters.
6. Limit or exclude contact of the child with pigeons, chickens and other farm animals.

Expert advice

1. Gastric lavage in a child can be done in this way: offer to drink a glass of liquid, then press your finger on the tip of the tongue, causing vomiting. The rinsing continues until the rinsing waters are clear. Remember that gastric lavage on your own at home should not be done for children under 3 years old! It is undesirable to use a spoon to induce a gag reflex, as metal can damage soft tissues oral cavity.
2. Self-medication and treatment folk methods with salmonellosis is unacceptable.
3. For prophylactic purposes, a salmonella bacteriophage can be prescribed to family members of a sick child.
4. After the illness, the child develops immunity, which lasts up to 12 months.
5. Food prepared for a child should not be stored. Otherwise, it must be reheated to a temperature of 70 C.

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Salmonellosis symptoms in children

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One of the most common dangerous intestinal diseases is salmonellosis. Symptoms and treatment in adult patients are practically no different from the signs and treatment of the disease in children. But still, the course of the disease may have its own characteristics depending on the age of the patient.

What is salmonellosis?

How to treat salmonellosis, it is important to know even for those who have never encountered such a problem. After all, the disease has become so "famous" throughout the globe that every year the number of people who have been infected is steadily increasing. To understand the nuances of treating a disease, you need to know what kind of pathology it is, how it manifests itself and what consequences it is fraught with.

Salmonellosis belongs to the class of acute infectious diseases provoked by pathogenic microorganisms. In particular, the causative agent of this disease is salmonella. In most cases, with timely diagnosis and timely therapy, the prognosis for recovery is quite favorable.

How does infection occur?

Salmonellosis in children, the symptoms and treatment of which raise a lot of questions from parents, proceeds in the form of dysfunction of the digestive tract. The most common manifestations are gastroenteritis and colitis. It is not difficult to become infected with this disease, especially since the source of infection is often the people themselves, as well as birds and animals. Signs of salmonellosis in humans (how to treat the disease - only a doctor will answer this question, self-medication can be dangerous) most often appear in the hot summer season.

In addition, salmonella often settles in the human body after eating contaminated foods. The harmful microorganism can be found in meat, milk, butter or dirty untreated water. With insufficient heat treatment, bacteria remain in the product, entering the gastrointestinal tract. It is almost impossible to discern the presence of salmonella, for example, in a piece of meat: it does not have the slightest effect on the taste of contaminated products or their appearance.

Who is at risk?

In order for a pathogenic bacterium to enter the body through the oral-fecal route, it is enough simply not to wash your hands once after using the toilet or upon returning home from the street. It is not surprising that the question of how to treat salmonellosis is of most concern to parents. Children under the age of 12 are the main risk group for infection, since they most often do not follow the basic rules of personal hygiene. Infant infections are most malleable, since babies do not yet have time to develop strong immunity.

Incubation period and manifestations of salmonellosis

4 days after infection, salmonellosis will begin to manifest itself. Symptoms and treatment in adults are usually determined by the presence of an incubation period during which certain signs of the disease may occur. The absence of pronounced symptoms can be called one of the main reasons for the impossibility of timely early therapy.

Meanwhile, after a 4-day latent phase infectious disease, patients at any age begin to be disturbed by painful unpleasant manifestations, similar to signs food poisoning, among which:

• pain and pain in the abdomen;
• flatulence, constant sensation swelling;
• prolonged diarrhea accompanied by a fetid odor;
• the possible presence of blood or mucus in the feces;
• persistent vomiting, nausea;
• dehydration of the body;
• refusal to eat due to lack of appetite;
• high body temperature;
• feeling of ache in muscles and bones;
• mild neurological symptoms.

The last group of signs of infection include dizziness, migraine and sleep disturbances. If any of the above symptoms appear, it is important to isolate the patient from other family members as soon as possible. The predominant part of intestinal infections is characterized by a high degree of spread of the disease.

Features of children's symptoms

Salmonellosis in children has a distinctive feature. Symptoms and treatment largely depend on dehydration. In childhood, this sign of infection is considered the most dangerous. In babies under 1 year old, dehydration from salmonellosis can develop in a matter of hours. In this case, a group of additional symptoms appears:

• dryness in the mouth;
• lack of tears during crying;
• general weakness of the body;
• pallor of the skin;
• cold extremities;
• drowsiness.

Hospitalization and diagnosis

For adults, the state of dehydration is also a danger. In severe cases, with a complicated course of the disease, the patient may even fall into a coma, therefore, at the first sign of a significant loss of fluid, urgent hospitalization is necessary, especially for pregnant women and the elderly.

Before treating salmonellosis, it is important to do all the necessary laboratory research. The doctor will give the patient a referral for a stool test, a biochemical and a clinical blood test. Further actions are possible only after the doctor makes an accurate diagnosis and confirms salmonellosis. From what the infection occurred, it can also matter for a specialist, therefore, often with this infection, the remains of undigested foods in the esophagus are taken for research.

Drinking plenty of salmonella

Before starting a serious drug therapy aimed at the maximum elimination of pathogenic bacteria in the patient's body, it is necessary to adjust the diet and drinking regimen. The primary task of doctors in inpatient facilities where salmonellosis is treated is to restore the patient's fluid and electrolyte balance. Dehydration can be cured with regular plentiful drink. As a rule, doctors recommend:

• weak tea (black or green) without sugar;
• mineral water in small sips;
• saline solution.

Diet for intestinal infections

Dieting is an equally important fundamental step in the treatment of salmonellosis. The task of a limited diet is to restore the full functioning of the digestive organs. Therefore, any products that can have an irritating effect on gastrointestinal tract the patient is completely excluded from the daily menu until complete recovery. Among them:

• raw vegetables and fruits (you can only eat boiled, steamed, stewed and baked);
• any bread (white and black);
• mushrooms:
• whole milk;
• animal fats;
• seafood;
• sausages, semi-finished products, fast food;
• confectionery;
• carbonated drinks, coffee, alcohol.

Drug therapy for adults

Since it is impossible to treat salmonellosis without drugs, it is worth considering in detail the list of drugs prescribed to patients. Average, drug therapy Salmonella intestinal infections rarely last more than 10 days. Meanwhile, how much salmonellosis is treated depends largely on the patient's condition.

As already mentioned, at the beginning of treatment it is extremely important to eliminate dehydration, which occurs due to intense vomiting and diarrhea. A drug such as Loperamide will help slow down the activity of the intestines. Manufacturers do not recommend taking it for more than 5 days.

An antibiotic for salmonellosis is prescribed in the case when the disease is severe. The drug is first administered to the patient intravenously. After relief, go to oral intake or intramuscular injections. The most common antibacterial drugs are:

• "Azithromycin".
• "Ciprofloxacin".
• "Cefotaxime".
• "Ceftriaxone".

Cleansing the body of bacteria

For headaches and high fever, Ibuprofen, Paracetamol are prescribed. Cleansing the intestines with an enema is considered effective and useful for salmonellosis. In addition, sorbents, which are considered indispensable for intestinal infections, will help remove all toxins from the body. The most famous drugs can be called Enterosgel, Smecta, activated carbon.

For the subsequent normalization of the activity of the organs of the digestive system, the doctor prescribes enzyme-containing preparations (Festal, Mezim, Creon). After undergoing antibiotic treatment, it is imperative to drink a course of probiotics, which will help restore the disturbed microflora in the intestine. It is necessary to take such medicines for a long time, at least 2-3 weeks. Effective means, which include live bacteria, are Lactobacterin, Bifidumbacterin, Acipol.

The nuances of treating children from salmonellosis

As such, there is no cure for salmonellosis for the treatment of children. The same drugs are used as for adult patients, but in a different dosage. First of all, it is necessary to solder the sick child. To remove all kinds of toxins from the body, it is advisable to give a teaspoon of water or other drink every 5 minutes. In cases of severe dehydration, doctors may prescribe glucose drips.

Antibiotics and antipyretics for a child can only be prescribed by the attending doctor. In no case should you self-medicate. The restrictions that apply to adult patients fully apply to children. It is necessary for a child to adhere to a diet for as long as possible, since it will be difficult for a weakened baby's body to cope with a sharp load on the digestive system.

Folk recipes for intestinal infections

Folk remedies for salmonellosis, unfortunately, do not guarantee one hundred percent positive result. Meanwhile, in combination with drug therapy and diet, homemade recipes for getting rid of an intestinal infection can be an additional option that speeds up treatment. However, it is advisable to approach the use of agents that are absolutely safe at first glance with caution. It is advisable to use at least one of the following recipes only after consulting a doctor.

1. Plantain infusion. You can cure salmonellosis with herbal medicine if you prepare it at the rate of: 1 tbsp. l. crushed leaves a glass of boiling water. It is necessary to brew this infusion for 10-15 minutes, after which you should drink home remedy small sips.
2. Walnut tincture is considered effective against intestinal infection. To prepare it, you will need to take a glass of peeled fruits and 2 glasses of vodka. Put the medicine in a dark place for 3-4 days. It is necessary to use the resulting remedy every 2 hours, 5 drops for children (diluted in 1 tbsp. boiled water) and 10 drops for adults.
3. To maintain the overall resistance of the organism by the most effective tool considered an infusion of chamomile officinalis. For 1 st. l. collection requires 1 cup of boiling water. In a metal container, put the medicine on a slow fire and cook for about 5 minutes. When the broth has cooled and infused, you can use it. For an adult patient, the medicine should be taken at least 4 times a day, 2 tbsp. l. after meal.
4. Essential peppermint oil will help eliminate stomach pain with salmonellosis. It is applied externally, a few drops are enough, after which the product is rubbed into the skin with gentle circular movements. Such a massage can also be done to improve intestinal motility.

Possible complications of salmonellosis

The symptoms of the disease cannot be ignored. Any intestinal infection provoked by a pathogenic microorganism is dangerous to the health and life of the patient. Untimely belated therapy to eliminate bacteria in the body is fraught with negative dangerous consequences, among which:

• heart and kidney failure;
• sharp jumps in blood pressure;
• respiratory arrest, collapse.

In addition, purulent complications can occur from all internal organs and systems. With salmonellosis, these are often:

• peritonitis;
• appendicitis;
• arthritis.

At an advanced stage of the disease, bacteria, reaching through the bloodstream to meninges, can provoke inflammation and encephalopathy. Infectious-toxic shock, as well as exacerbation of chronic diseases (pancreatitis, cholecystitis) are rare in patients, but such complications in most cases can end in failure. Rarely, salmonella causes problems with blood clotting.

Intestinal infections are very common among children. This is not surprising, because kids try to taste the world around them from a very early age.

Among intestinal ailments, one of the leading places belongs to salmonellosis. We will talk about how this disease occurs in children, and how to treat a child, in this article.

What it is

An acute intestinal infection called salmonellosis affects both humans and animals equally. Moreover, among the total mass of cases, most of them are children of preschool and school age. However, the disease can be diagnosed in both newborns and infants. No one is immune from infection.

The disease is quite difficult, especially in children. Like most intestinal infections, salmonellosis is more common in summer when it is hot, because in hot weather it is much more difficult to comply with all the rules for storing food.

If salmonellosis occurs, the child must be provided with the correct and timely help, and a lot of this depends on the parents, on how quickly they can recognize the first signs of a bacterial infection.

Causes

The causative agent of the disease is salmonella - a bacterium in the form of a stick. The microbe is quite common, but it cannot boast of excellent health and endurance.

salmonella fast dies when heated to 50-55 degrees, but survives well when frozen. Dislikes wand and sunlight.

Ideal conditions for bacterial growth are the intestines of humans and animals. At a temperature of about 37 degrees, microbes feel great and are able to reproduce. When it enters the body of a child, salmonella behaves quite aggressively, and not only in relation to its carrier, but also to its other brethren.

If the bacterium is fixed on the intestinal wall, it begins to produce a strong toxin that destroys some of the other Salmonella that are competitors for it in the redistribution of the habitat.

The toxin affects the child's body, causing symptoms of intoxication, disturbances in the work of the gastrointestinal tract. This toxin also has one more unpleasant property - the body under its action begins to rapidly lose water through the intestines. For a child, this is fraught with rapid dehydration.

More than 1600 serotypes of Salmonella are known to science. Not everyone causes salmonellosis, there are microbes that cause typhoid fever, including typhoid fever.

Ways of infection

A child can become infected with salmonella in different ways:

• Food way. Infection occurs when eating animal products that contain the bacterium. Usually it is chicken, fish, meat, milk, eggs that have not undergone sufficient heat treatment (the microbe dies when heated).
• contact path. In this case, infection occurs from child to child with common toys, a pacifier. Adults who care for him can infect a child. The microbe first enters the skin or mucous membranes and is gradually transferred by the child into the mouth.

• vertical path. This is the transmission of salmonella from mother to child during pregnancy.
• Air way. Such infection occurs infrequently, but it is not excluded. The child inhales bacteria with dust, air in the focus of infection. Become such a hotbed, for example, kindergarten if there are already several children sick in it, or a school class.
• Waterway. The microbe enters the child's body with water

Quite often, a child becomes infected after contact with homeless animals. Therefore, it is worth thinking carefully before allowing the baby to stroke a stray cat or dog.

Danger and Consequences

Salmonellosis is dangerous, especially for newborns and children under one year old. A specific microbial toxin causes rapid dehydration, which can be fatal, and also cause severe complications from the most various organs and systems, most often - from the nervous system.

If the immune system is strong enough, then the disease will affect only the intestinal walls, the effect of the toxin on other parts of the body will be minimal. But kids usually brag strong immunity they cannot, the natural defense of the body is just being formed in them. That is why in the risk group - all babies without exception.

Salmonellosis can be especially severe in premature babies, in babies who often get sick, in children with existing chronic diseases, immunodeficiency.

A sick child is also a danger to other children - with a mild form of the disease, bacteria continue to be released into the environment from 2 to 4 weeks, with a severe form - up to 3 months or even longer. That is how long the baby is contagious.

Immunity to the bacterium is not produced, and re-infection occurs relapse.

The danger of the disease also lies in the likelihood of its chronicity: if the treatment is not done correctly, chronic salmonellosis will make the child not just a carrier of the bacterium - from time to time unpleasant and dangerous relapses will occur.

The mortality rate for salmonellosis in children is estimated at 0.2-0.5%. In most cases, it is possible to do without complications.

Incubation period

The duration of the incubation period for different children varies quite a lot - in some babies, only 6 hours pass between infection and the appearance of the first signs, while in others it takes three days. But most often the incubation period is from 12 to 24 hours.

If after that pronounced intestinal infectious symptoms, then they talk about acute course diseases. In some cases, the symptoms are erased or do not appear at all. Such children become carriers of the bacteria. They themselves do not suffer from the disease when they are carriers, but actively infect others, without suspecting it themselves.

The incubation period in newborns is usually shorter than in older children. In most cases it is only 2-4 days, and sometimes the disease develops in 3-5 hours.

Symptoms

The first signs of the disease usually appear immediately after the end of the incubation period. These are the classic symptoms of an intestinal infection:

• Temperature increase. The fever can be high, up to 38.5-39.0 degrees, but more often there is a rise in temperature at the level of 37.5-38.0 degrees.
• Weakness. A child under the action of a toxin on the nervous system becomes depressed, drowsy, capricious, he has a headache.
• Digestive disorders. With salmonellosis, frequent loose stools are observed. Feces are watery, frothy, with a sharp bad smell. Vomiting is pronounced, frequent.
• Abdominal pain. Pain in the abdomen may be accompanied by increased gas formation, a feeling of fullness, heaviness.

Depending on which serotype of the bacterium caused the disease, the course of the disease can be not only intestinal, but also generalized, when other organs and systems are involved in the pathogenic process.

Most often suffers nervous system, the spleen and liver may increase in size, and in severe form of the disease the development of renal failure against the background of severe dehydration is not excluded.

Quite often in children, salmonellosis is manifested by unpleasant symptoms from the cardiovascular system. going down arterial pressure, violated heartbeat pulse speeds up.

Sometimes the generalized form of the disease occurs 2-3 days after acute intestinal in the absence of assistance and appropriate treatment. Symptoms in this case may be similar to typhus. To all of the above, the appearance on the skin of a small dotted rash of the type of hemorrhagic is added.

Spot rash

The symptoms of salmonellosis in children of the first year of life and newborns have their own characteristics. Such small patients usually have the following "set" of symptoms:

• Copious frequent regurgitation. It will differ from the physiological one in frequency and volume, as well as in the sour smell of the rejected masses.
• Severe restlessness and sleep disturbances. This is the action of Salmonella toxin, which causes overexcitation. Toddlers are more susceptible to poison than older children.
• Bloating. The baby's tummy looks bloated, like a frog's, loose stools with mucous impurities, colic are possible.

• Signs of dehydration. Such signs include crying without tears, cold extremities, cyanosis under the eyes, in the area of ​​the nasolabial triangle, dry skin.
• Falling fontanel. The fontanel looks somewhat concave inward.

But the baby's temperature can rise only after a few days after the onset of the disease.

Diagnostics

Distinguishing salmonellosis from other types of intestinal viral and bacterial infections is quite difficult, since the symptoms are very similar. It will help to establish the truth laboratory diagnostics, which is always carried out at the slightest suspicion of Salmonella infection.

If a child is suspected of having this disease, they try to hospitalize him in a specialized infectious diseases hospital, and All studies are carried out on the basis of a medical institution.

To date, bakposev is considered the most reliable and accurate. For analysis, feces and vomit samples are taken.

On a nutrient medium laboratory conditions grow microorganisms. The resulting microbes are identified by type, family, serotype, and also set to which antibiotics they are sensitive. This makes it possible to choose the right drug for treatment.

The disadvantage of bacteriological analysis is that the growing process sometimes takes several days, and sometimes even drags on for a week and a half.

Naturally, the child cannot not receive treatment all this time. That is why materials are sent for bakposev to make sure that the doctors' versions were correct, but they quickly resort to other diagnostics.

Express analysis is based on the use of special test systems that detect antibodies to Salmonella by immunofluorescence. Such a test, conducted by an experienced laboratory assistant, will allow in a few minutes to answer the question of whether there is salmonella in the body, but, alas, will not be able to tell what type of bacteria caused the infection.

In the process of treatment, the child will take blood several times for a serological analysis, which will make it possible to judge how effective the therapy is. In the laboratory, antibodies and their number will be determined, as well as the dynamics - growth and decline - will be assessed.

Treatment

Salmonella have been around humans for so long that they have developed sufficient protection against many types of antibiotics. So, they are almost impossible to destroy with the help of tetracyclines and aminoglycosides. But antimicrobials of the penicillin group and fluoroquinolone antibiotics can be quite effective.

With mild illness antibiotic therapy the child is trying not to prescribe. The main indication for the use of such drugs is such a clinical sign as the presence of blood in the stool. If there is no blood, then in mild cases, antibiotics are not required at all.

Mild degrees of the disease can be treated at home. Naturally, parents will have to carefully follow all the recommendations of the doctor.

In the first day or two, it is advisable for a child with confirmed salmonellosis to perform a gastric lavage and an enema. If the baby has frequent loose stools, after washing, he is prescribed calcium preparations in an age dosage.

And after repeated vomiting, and after prolonged diarrhea, it is mandatory to take oral rehydration agents - "Smekty", "Regidron", "Humana Electrolyte" and others.

The child should be given such solutions often and in in large numbers

If the baby refuses to drink on his own, use a syringe without a needle, pouring in solutions in such a way that the liquid passes along inside cheeks. So the baby will less chance spit it back immediately.

These solutions contribute to the restoration of mineral salts, water balance, which will prevent the development of dehydration. In addition to these solutions, should be allowed to drink ordinary warm water, dried fruit compote without sugar, weak tea.

If you can’t get the baby to drink in any way, then you should return to the hospital, where the child, under the supervision of doctors, will be given electrolytes intravenously so that dehydration does not occur.

The child is on a strict diet. While the acute stage is in full swing, you do not need to feed the baby at all, it will be enough to drink plenty of water. On the second or third day, if the child himself asks for food, they begin to give light meals that will not additionally irritate the intestines and stomach.

Completely prohibited:

• milk and dairy products;
• products containing animal fats;
• chocolate;
• sour fruits and berries;

• seasonings and spices;
• smoked products;
• sparkling water;
• pickled food;
• fried food.

You can feed your child with foods and dishes from the following list:

• porridge-smear without milk and butter;
• soup with vegetable broth;
• boiled fish;
• steam cutlets from lean meat;
• jelly.

Food should not be served hot: everything that is prepared for the child is pre-cooled to room temperature.

Overeating is not allowed. The volume of food is increased gradually as you recover, starting with a small amount of broth or porridge and leading to a full serving by the end of the course of treatment.

The most commonly prescribed antibiotics Suprax, Cefixime, with diarrhea - "Enterofuril" in capsules, which, although it is antimicrobial agent, but it is not considered an antibiotic in the full sense of the word.

With a generalized infection, antibiotics of the penicillin group are prescribed for intramuscular administration.

Most cases of mild And medium degree disease, the most effective is to take a special salmonella bacteriophage - a virus that is grown artificially, and which feeds on salmonella.

A drug "Salmonella bacteriophage" exists in liquid form and in the form of tablets.

Salmonellosis is an acute infection of the digestive system caused by Salmonella bacteria. The disease is accompanied by severe intoxication of the body and increased loss of water. In children, salmonellosis can occur like typhoid fever or with septicemia.

Most often, outbreaks of Salmonella infection occur in the warm season after eating products whose storage conditions and preparation technology have been violated. Salmonella activity causes damage to the gastrointestinal tract in children, and in complicated cases - internal organs and lymphatic system. Therefore, at the first signs of a child’s illness, it is necessary to hospitalize and take all necessary measures to fight the pathogen.

Causes and ways of infection

Salmonella is able to develop not only in the human body, but also in animals. There are over 700 species of this bacterium that can cause salmonellosis in humans. They are very stable in the external environment, but die when high temperatures. They develop especially actively in eggs, meat and dairy products, and butter. Toxins produced by bacteria damage the intestinal mucosa, increase the secretion of fluid and salts.

How is salmonellosis transmitted? A child can get infected mainly from animals, less often from another person. Waterfowl are a particularly dangerous source of salmonellosis.

Main routes of infection:

• food- bacteria enter the gastrointestinal tract of a child due to the intake of contaminated food. This happens due to insufficient heat treatment. There is also a risk of infection through unboiled water.
• Contact household- usually occurs in infancy. Salmonella is transmitted to a child through the unclean hands of medical staff or parents, through toys, pacifiers, care items, inhalation of contaminated dust.
• Transplacental- the bacterium enters the fetus in utero or through mother's milk.

Children under 2 years of age are especially susceptible to salmonella. First, the pathogen is localized in the small intestine. In the process of reproduction, it penetrates into the bloodstream and lymph flow.

Symptoms and types of disease

Since salmonellosis is a group of infections, clinical manifestations and its severity may differ depending on the form of the disease.

There are typical (gastrointestinal, septic and typhoid-like) and atypical (erased, subclinical, bacteriocarrier) forms of salmonellosis.

The incubation period of salmonellosis in children can last from a couple of hours to 7 days, depending on the form of the disease and the amount of the pathogen that has entered the body.

For any form of the disease are characteristic:

• acute onset and fever;
• frequent stools with a fetid odor;
• dehydration (dry mucous membranes and skin).

In infants, general intoxication prevails over intestinal disorders. The temperature may remain within the normal range. Children gain weight poorly, are restless, regurgitation often occurs, the fontanel sinks from dehydration.

Gastrointestinal toxic infection

The most common form in children. Different parts of the digestive organs are affected, depending on this, the infection can occur in the form of gastritis, enterocolitis, gastroenteritis.

Signs of the disease:

• temperature 39-40 o C or subfebrile;
• vomit;
• abdominal pain;
• copious loose stools undigested food, greenery, the smell is sharp, sour;
• slight bloating;
• dehydration due to frequent vomiting and loose stools.

The child manifests general intoxication, the heartbeat quickens, convulsions appear, cold sweat. Asthenia and low blood pressure can persist for a long time after the disappearance of acute symptoms of infection.

typhoid form

The child has a fever and confusion. Attacks can occur in waves with periods of calm. They last about 14 days (as in typhoid).

Characteristic signs of salmonellosis:

• loose watery stools up to 3-5 times a day;
• bouts of vomiting;
• flatulence;
• general intoxication with malaise, weakness, headache;
• dryness and thickening of the tongue;
• hemorrhagic rashes on the skin;
• the liver may be enlarged.

septic view

It is one of the most dangerous. It is not common and mostly in infants.

Symptoms of salmonellosis in children:

• high temperature (up to 40 ° C and more);
• diarrhea, vomiting;
• damage to the brain and its membranes;
• fever with chills and excessive sweating;
• loose stools with mucus and blood;
• tachycardia.

After the disease, some children continue to release bacteria into the external environment for about a month. If such carriage is observed for more than 3 months, then the disease becomes chronic.

90-95% of children develop acute process diseases. After 5-7 days, signs of intoxication disappear. In severe cases, a violation of the stool can be observed for another month.

Possible Complications

Salmonellosis is dangerous for a child because the bacteria can spread throughout the body and form local foci of infection of internal organs. The disease significantly reduces immunity, causes exacerbation of chronic ailments or the accumulation of new ones.

Complications of salmonellosis:

• swelling of the brain and lungs;
• kidney failure;
• peritonitis;
• reactive arthritis;
• abscess of internal organs.

Parents take note! If you suspect salmonellosis, immediately show the baby to a specialist. If left untreated in the early days of illness, young children can be fatal.

Diagnostics

The child must be shown to an infectious disease specialist or gastroenterologist at the first sign of Salmonella infection. A doctor can preliminarily diagnose an acute intestinal infection. You can identify the pathogen using the following examination methods:

• analysis of feces for dysbacteriosis;
• general blood test;
• bacteriological culture of vomit;
• coprograms;
• RNGA blood.

Effective Treatments

How to treat salmonellosis? Therapy must be strictly individual. Many types of Salmonella are resistant to antibiotics, so they are prescribed in exceptional cases. The main role is given to nutrition, elimination of toxins and elimination of dehydration. In mild cases, treatment can be carried out at home, in severe cases, hospitalization of the child is required.

Rules of nutrition and diet

From the first days of illness, the child is assigned table number 4. Food should be ground and boiled.

Allowed products:

• oatmeal or rice boiled in water;
• boiled fish;
• steam cutlets;
• fruit jelly;
• meatballs;
• cottage cheese;
• hard cheese with 0% fat.

Animal fats, milk, coarse fiber are prohibited.

This diet should be followed for a month. You need to expand the menu gradually, with full recovery, switch to your usual diet.

Elimination of toxins

The first aid that must be provided to the sick is gastric lavage. This will alleviate his condition, remove some of the toxins. Self-washing is allowed only for children older than 3 years.

The procedure requires 2% sodium bicarbonate solution or water (2-3 l). The liquid should be warm (about 20 o C). The child should drink a glass of liquid. Then he needs to induce vomiting by pressing on the root of the tongue with his fingertips. Repeat until the rinse water is clear.

Dehydration Correction

A sick child after gastric lavage is carried out oral rehydration. To do this, prepare a solution from the powder:

• Oralita;
• Regidron;
• Glucosolan.

The child should drink a solution of ½-1 teaspoon every 5 minutes. With a mild course of the disease, you need to drink 30-40 ml of solution per 1 kg of weight per day. With severe intoxication - 70 ml per 1 kg of weight. It is necessary to replenish water-salt losses within 2-3 days until the signs of toxicosis disappear.

With frequently repeated vomiting and the inability to administer the solution orally, rehydration is carried out intravenously with a glucose solution. The amount of fluid that was excreted with diarrhea and vomiting should be replenished in full.

On the page, read about the symptoms and treatment of conjunctivitis in a child.

Drug therapy

In the case of severe forms of salmonellosis, after detecting the sensitivity of salmonella, antibiotic therapy is performed. The doctor may prescribe antibiotics of the following groups:

• Penicillins (Amoxiclav, Ampicillin, Flemoxin, etc.);
• Cephalosporins (Cefix, Ceftriaxone);
• Aminoglycosides (Netilmecin);
• Carbopenems (Meropenem).

Enterosorbents:

• Smecta;
• Polysorb;
• Atoxil.

To normalize the intestinal microflora, the intake of probiotics is indicated:

• Duphalac;
• Bificol;
• Linex.

Enzymes to improve digestion:

• Mezim;
• Festal;
• Enzistal.

Surveillance of those who have been ill

If a child has been ill with salmonellosis, he is put on a dispensary record. Monthly it is necessary to take an analysis of the material for bakposev. At negative result for the presence of salmonella, the child is removed from the register. He can visit children's institutions.

Those who have been in contact with the infected are observed for 7 days. They also conduct a bacteriological analysis of feces. If the analysis is negative, the person is considered healthy. Since the source of salmonellosis is mainly contaminated food, it is subjected to research. Disinfection is carried out in the focus of salmonellosis.

Preventive measures

• Food must be carefully thermally processed, especially products of animal origin.
• If there is already a carrier of the infection in the house, he needs to allocate separate hygiene products and utensils.
• Do not allow the child to take things from the floor and dirty toys into his mouth.
• Toys need to be washed more often with soap.
• Do not swim in suspicious and dirty water bodies.
• Limit the contact of the child with farm animals (ducks, chickens).

Salmonellosis in most cases ends with recovery without severe consequences. A dangerous disease is for infants and debilitated children. Therefore, you should especially carefully monitor their nutrition. Before giving any product to a child (especially meat and confectionery products), you need to check its good quality, conditions and shelf life.

Video. Famous children's doctor Komarovsky and salmonellosis: