Characteristics of non-typhi Salmonella gastroenteritis associated with bacteremia in infants and young children.

PURPOSE: To characterize the clinical and laboratory manifestations of non-typhi Salmonella gastroenteritis associated with bacteremia in children less than 36 months old.

METHODS: The study group included 17 patients, aged 2-34 months, with non-typhi Salmonella gastroenteritis and bacteremia, hospitalized in a tertiary pediatric medical center during the period 1995-2010. Clinical data were collected by medical chart review. Culture-related data were taken from the microbiology laboratory files. The results were compared with an assigned, age-matched, control group of 17 infants hospitalized with non-typhi Salmonella gastroenteritis without bacteremia.

RESULTS: Eleven cases (65%) occurred during the summer season. All patients presented with diarrhea, usually mixed with blood or mucus (clinical dysentery 65%). All but one had a high-grade fever (average 39.5°C). Three patients (19%) experienced convulsions during the acute episode of gastroenteritis. None of the patients had been previously treated with antibiotics. The most prevalent Salmonella serotype identified in the stool and blood was group C. Toxic appearance and convulsions on admission were more common among children with non-typhi Salmonella bacteremia, as opposed to those with non-typhi Salmonella gastroenteritis alone. No other epidemiological or laboratory differences were found.

CONCLUSIONS: Non-typhi Salmonella gastroenteritis poses a risk of bacteremia not only in infants younger than 3 months of age, but also in children younger than 36 months of age.