Symptoms of Salmonella Infection
An infectious dose of Salmonella is small, probably from 15 to 20 cells. Typically, non-typhoidal Salmonella produces a self-limiting febrile gastrointestinal illness that is indistinguishable from that caused by other bacterial enteric pathogens. Dehydration is the principal clinical concern. The incubation period – the time between ingestion of Salmonella bacteria and the onset of illness – varies from six to 72 hours (Mayo Clinic, 2007, April 12; MMWR Recomm Rep, 2001).
Salmonella can cause three different kinds of illness: gastroenteritis, typhoid fever, and bacteremia.
Symptoms of Salmonella gastroenteritis include diarrhea, abdominal cramps, fever, nausea, and/or vomiting. In mild cases diarrhea may be non-bloody, occur several times per day, and not be very voluminous; in severe cases it may be frequent, bloody and/or mucoid, and of high volume.
Fever generally occurs in the 100°F to 102°F (38°C to 39°C) range. Vomiting is less common than diarrhea. Headaches, myalgias (muscle pain), and arthralgias (joint pain) are often reported as well. Whereas the diarrhea typically lasts 24 to 72 hours, patients often report fatigue and other nonspecific symptoms lasting 7 days or longer.
Complications of Salmonella Infection
Typhoid fever, also known as enteric fever, is caused by Salmonella serotype typhi. The onset of symptoms usually occurs between 5 and 21 days after ingestion of Salmonela typhi bacteria. Symptoms may include constipation, cough, sore throat, headache, and a rash on the infected individual’s chest, as well as the slowing of the heartbeat and enlargement of the liver and spleen (Mayo Clinic, 2007, April 12).
Bacteremia is characterized by infection of tissues surrounding the brain and spinal cord (meningitis) and infection within the bloodstream (sepsis). This condition occurs when Salmonella enter and circulate within an infected individual’s bloodstream, and is accompanied by few symptoms (Mayo Clinic, 2007, April 12).
Reiter’s syndrome, which includes and is sometimes referred to as “reactive arthritis” is an uncommon, but debilitating, result of a Salmonella infection. Reiter’s syndrome is a disorder that causes at least two of three seemingly unrelated symptoms: reactive arthritis, eye irritation, and urinary tract infection (Hill Gaston & Lillicrap, 2003). The reactive arthritis associated with Reiter’s develops when a person eats food that has been tainted with bacteria. Reactive arthritis is characterized by the inflammation of one or more joints following an infection localized in another portion of the body, commonly the gastrointestinal tract. The symptoms of Reiter’s Syndrome usually occur between one and three weeks after the infection.
The three most common symptoms of Reiter’s syndrome are arthritis, eye irritation, and urinary tract symptoms. The arthritis associated with Reiter’s syndrome typically affects the knees, ankles, and feet, causing pain and swelling. Wrists, fingers and other joints can be affected, though with less frequency. Patients with Reiter’s syndrome commonly develop inflammation where the tendon attaches to the bone, a condition called enthesopathy. Some patients with Reiter’s syndrome also develop heel spurs, bony growths in the heel that cause chronic or long-lasting foot pain. Arthritis from Reiter’s syndrome can also affect the joints of the back and cause spondylitis, inflammation of the vertebrae in the spinal column. The duration of reactive arthritis symptoms can vary greatly. Most of the literature suggests that the majority of patients recover within a year. The condition, can, however, be permanent. One study found nearly 50 percent of patients with post dysenteric reactive arthritis continued to have symptoms roughly one year after onset (Inman, et al., 1998).
The involvement of the eye in Reiter’s syndrome is most commonly manifested as conjunctivitis, inflammation of the mucous membrane that covers the eyeball, or uveitis, an inflammation of the inner eye. Conjunctivitis and uveitis can cause redness of the eyes, eye pain and irritation, and blurred vision.
The third site for Reiter’s syndrome symptoms is the urogenital tract. This includes the prostate, urethra, and penis in men and the fallopian tubes, uterus, and vagina in women. Men may notice an increased need to urinate, a burning sensation when urinating, and a discharge from the penis. Some men also develop prostatitis. Symptoms of prostatitis include fever, chills, increased need to urinate, and a burning sensation when urinating.