Abstract
Nontyphoidal Salmonella (NTS) infections are primarily transmitted by contaminated food or water or contact with carrier animals (particularly reptiles), and present with diarrhea. Antibiotics do not decrease the severity or duration of diarrhea and may increase the incidence of NTS carriage, so they should only be used with suspected or proven bacteremia or invasive infection. Typhoid/paratyphoid fever manifests as bacteremia within 60 days of travel to resource-poor countries and presents with fever and variable abdominal complaints. Therefore, blood cultures are indicated for unexplained fever and a relevant travel history. When blood cultures are positive or when a child is unwell pending blood culture results, ceftriaxone is indicated. A switch to oral antibiotics (usually azithromycin) is often possible after blood cultures have cleared and the child is improved.
Keywords: Nontyphoidal Salmonella, Typhoid/paratyphoid fever
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CANADIAN PAEDIATRIC SOCIETY INFECTIOUS DISEASES AND IMMUNIZATION COMMITTEE
Members: Michelle Barton-Forbes MD; Natalie A. Bridger MD; Shalini Desai MD; Michael Forrester MD; Ruth Grimes MD (Board Representative); Charles Hui (past member); Nicole Le Saux MD (Chair); Joan L. Robinson MD (past Chair); Otto G. Vanderkooi MD (past member)
Liaisons: Upton D. Allen MBBS, Canadian Pediatric & Perinatal HIV/AIDS Research Group; Tobey Audcent MD, Committee to Advise on Tropical Medicine and Travel (CATMAT), Public Health Agency of Canada; Carrie Byington MD, Committee on Infectious Diseases, American Academy of Pediatrics; Fahamia Koudra MD, College of Family Physicians of Canada; Marc Lebel MD, IMPACT (Immunization Monitoring Program, ACTIVE); Jane McDonald MD, Association of Medical Microbiology and Infectious Disease Canada; Dorothy L. Moore MD, National Advisory Committee on Immunization (NACI); Howard Njoo MD, Public Health Agencyof Canada
Consultant: Noni E. MacDonald MD
Principal author: Joan L. Robinson MD