Salmonellosis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jolanta Marszalek, M.D. [2]

Overview

Salmonellosis must be differentiated from other types of infectious diseases that can cause acute inflammatory diarrhea. It is important to consider other underlying pathogens including Shigella, Campylobacter, E.coli, C. difficile, and E. histolytica.^[1]

Differentiating Salmonellosis from Other Diseases

Salmonellosis should be differentiated from other pathogens that lead to acute inflammatory diarrhea. The table below lists the underlying pathogens known to cause acute inflammatory diarrhea:^[1]^[2]

Pathogen	Transmission	Clinical Manifestations
Pathogen	Transmission	Fever	Nausea/Vomiting	Abdominal Pain	Bloody Stool
Salmonella	Foodborne transmission, community-acquired	++	+	++	+
Shigella	Community-acquired, person-to-person	++	++	++	+
Campylobacter	Community-acquired, ingestion of undercooked poultry	++	+	++	+
Escherichia coli	Foodborne transmission, ingestion of undercooked hamburger meat	–	+	++	+ (EHEC or EIEC), – (ETEC, EAEC, EPEC)
Clostridium difficile	Nosocomial spread, antibiotic use	+	±	+	+
Yersinia	Community-acquired, foodborne transmission	++	+	++	+
Entamoeba histolytica	Travel to or emigration from tropical regions	+	±	+	±
Aeromonas	Ingestion of contaminated water	++	+	++	+
Plesiomonas	Ingestion of contaminated water or undercooked shellfish, travel to tropical regions	±	++	+	+

References

↑ ^1.0 ^1.1 Thielman NM, Guerrant RL (2004). “Clinical practice. Acute infectious diarrhea”. N Engl J Med. 350 (1): 38–47. doi:10.1056/NEJMcp031534. PMID 14702426.
↑ Khan AM, Faruque AS, Hossain MS, Sattar S, Fuchs GJ, Salam MA (2004). “Plesiomonas shigelloides-associated diarrhoea in Bangladeshi children: a hospital-based surveillance study”. J Trop Pediatr. 50 (6): 354–6. doi:10.1093/tropej/50.6.354. PMID 15537721.

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[pmid14702426-1] 1.0 ^1.1 Thielman NM, Guerrant RL (2004). “Clinical practice. Acute infectious diarrhea”. N Engl J Med. 350 (1): 38–47. doi:10.1056/NEJMcp031534. PMID 14702426.

[pmid15537721-2] Khan AM, Faruque AS, Hossain MS, Sattar S, Fuchs GJ, Salam MA (2004). “Plesiomonas shigelloides-associated diarrhoea in Bangladeshi children: a hospital-based surveillance study”. J Trop Pediatr. 50 (6): 354–6. doi:10.1093/tropej/50.6.354. PMID 15537721.

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