Pediatric Salmonella Infection Clinical Presentation

Updated: Dec 08, 2021
  • Author: Archana Chatterjee, MD, PhD; Chief Editor: Russell W Steele, MD  more...
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Carefully obtain the patient's history to determine any potential sources of Salmonella and to help determine if the correct diagnosis has been made.

  • General history

    • Inquire about any recent travel abroad.

    • Inquire about possible animal exposures, including contact with pet iguanas, turtles, tortoises, or other reptiles.

    • Inquire whether any family members have current or recent gastroenteritis.

    • Inquire whether any recent outbreaks have occurred in the community.

  • Salmonella gastroenteritis

    • The incubation period of Salmonella gastroenteritis is 6-72 hours.

    • In most cases, children have cramping abdominal pain, nausea, vomiting, and loose watery stools.

    • Stools may be bloody; however, this is not as common as in infection with Shigella.

    • Fever, which rarely exceeds 39°C, occurs in approximately one half of infected patients.

    • Symptoms usually resolve spontaneously in 2-7 days.

  • Enteric fever (typhoid fever)

    • Enteric fever is caused by S. typhi and several other Salmonella serotypes.

    • The incubation period for enteric fever is 3-60 days, but symptoms typically occur in 1-2 weeks.

    • Patients may present with high fever, which rises in a steplike fashion.

    • Other symptoms include anorexia, abdominal pain, malaise, myalgias, headache, cough, diarrhea or constipation, and delirium.


Physical Examination

Physical findings may include the following:

  • Salmonella gastroenteritis

    • Upon physical examination, patients may have signs of dehydration, such as delayed capillary refill, sunken eyes, dry mucous membranes, or tachycardia.

    • Patients may have tenderness to palpation on abdominal examination, which sometimes can be difficult to differentiate from appendicitis.

    • Rectal examination may reveal heme-positive stools, gross blood, or mucoid stools.

  • Enteric fever (typhoid fever)

    • A typical finding of enteric fever is relative bradycardia for the height of the fever.

    • Hepatosplenomegaly may be found on examination.

    • Patients with enteric fever may develop rose spots; these spots are blanching pink papules most commonly found on the anterior thorax. They usually fade about 3-4 days after appearance, are 2-4 mm in diameter, and occur in groups of 5-20.