Salmonella Gastroenteritis and Liver Abscess

Pathogenesis and Risk Factors

Salmonella infections are 20-100 times more common in HIV-infected individuals than in the general population, with increased risk of bacteremia and extraintestinal spread, according to the Centers for Disease Control and Prevention (CDC) 1
The risk for more severe disease increases with the degree of immunosuppression, as stated by the CDC 1
Three major clinical syndromes of Salmonella infection include self-limited gastroenteritis, more severe prolonged diarrheal disease with fever and bloody diarrhea, and septicemia with potential extraintestinal involvement, including liver abscess, as reported by the CDC 1

Diagnosis of Salmonella-related liver abscess requires blood cultures and imaging studies to identify abscess formation, as recommended by the CDC 1
Fluoroquinolones, such as ciprofloxacin, are usually the drugs of choice for susceptible organisms, according to the CDC 2, 3

HIV-infected persons should receive antimicrobial therapy for Salmonella gastroenteritis to prevent extraintestinal spread, as recommended by the CDC 2, 3
HIV-exposed infants <3 months and all HIV-infected children with severe immunosuppression should receive treatment for Salmonella gastroenteritis, according to the CDC 2, 3
Pregnant women should receive treatment for Salmonella gastroenteritis due to risk of extraintestinal spread affecting the placenta and amniotic fluid, as recommended by the CDC 2, 3

Scrupulous handwashing can reduce risk of Salmonella infection, as stated by the CDC 1
Household contacts of infected persons should be evaluated for asymptomatic carriage, as recommended by the CDC 2, 3

Relapse in Salmonella infections after appropriate treatment is well-documented, particularly in immunocompromised patients, as reported by the CDC 1