Salmonellosis in children: causes, symptoms, treatment and dangers of salmonella infection. Salmonellosis in children: symptoms and treatment. Why is the evil fairy "salmonella" dangerous for the health of babies? Symptoms of salmonellosis in children

Failure to comply with cooking technology and hygiene rules can cause a serious infectious disease of the digestive system. Salmonellosis in children is often severe and life-threatening.

The onset of the disease is acute. The body temperature rises, frequent vomiting is possible, well-marked toxicosis, stool disorder, swollen abdomen. These are typical signs of salmonella infection in the body.

Treatment of salmonellosis in children infancy most often performed in a hospital. During the disease, dehydration of the body is observed, the function of the circulatory system is disturbed, the liver increases in size.

Salmonella bacteria are highly resistant to antibiotics, so their choice is limited. You can not self-medicate and if you suspect salmonellosis, you must contact the child with the clinic to confirm or refute the diagnosis.

With timely and proper treatment, recovery occurs. You can learn more about the disease and the expected treatment by reading the article to the end.

From this article you will learn

What is a disease

The bacterium that causes the disease is named after American veterinarian Salmon. He, along with Dr. Smith, isolated the causative agent of salmonellosis and invented the typhoid vaccine.

Salmonella is a bacterium in the form of a rod. It is pathogenic when it enters the food tract of humans and animals. Some types of these bacteria cause such dangerous diseases like typhus and paratyphoid.

The properties of these bacteria are interesting. They do not die when frozen, they can live outside a living organism for seven days.

Bacteria die at a temperature of +60 degrees in 12 minutes. Therefore, in properly cooked and heated food before eating, bacteria die.

Having settled on the walls of the intestines, salmonella begin to produce a deadly toxin, from which all other bacteria of the intestinal microflora die.

Ways of infection

Infection of the body occurs most often due to food products that contain live salmonella. The greatest threat is posed by milk, chicken or waterfowl eggs, meat and meat products.

Salmonellosis can affect not only people, but also animals. If they are contained in bad conditions may be contaminated with salmonellosis.

The lack of veterinary control in the markets and the purchase of contaminated products are the most common cause outbreaks of this dangerous infection.

Outwardly quite healthy man can also be a carrier of infection and release dangerous bacteria into the environment.

Therefore, at food enterprises, in grocery stores, children's institutions, when applying for a job, they must hand over the sowing tank.

Violation of product storage rules - joint storage of raw and cooked food, insufficient heat treatment of food before consumption, lack of processing chicken eggs before preparing creams, all this can also cause salmonellosis.

Dangerous bacteria are transmitted to a newborn baby with mother's milk or during intrauterine development through the placenta.

Clinical signs and forms of the disease

The course of the disease can be different. It is especially dangerous for young children. Dehydration of the body together with severe intoxication requires complex treatment in stationary conditions.

In the absence of treatment in the first days of the disease for an infant, a fatal outcome is possible.

Asymptomatic carriage of dangerous bacteria is possible, when an infected person can become a source of illness for others, but he himself does not even know about it.

This is one of atypical forms salmonellosis (there are also subclinical and erased).

The course and form of the disease depends on the number of bacteria that have entered the body, their type and the immunity of the infected person. Young children under two years of age are especially vulnerable.

From the moment of infection to the development of symptoms of the disease, it can take from two hours to several days. For all forms of illness characteristic symptoms are considered:

dehydration of the body;
acute initial period;
diarrhea several times a day, foul-smelling.

Infants may experience restless behavior, frequent regurgitation. Dehydration is expressed in the fact that the fontanel sinks. The baby is not gaining weight.

The most common form of the disease is gastrointestinal toxicoinfection. Its symptom is damage to the digestive organs, accompanied by pain in the abdomen, cold sweat, reduced pressure, heart palpitations.

Body temperature is often greatly increased (forty degrees). The body becomes dehydrated due to frequent vomiting and diarrhea. The stools are offensive, with particles of food and mucus.

There is a septic form of the disease (the most dangerous), which is accompanied by dyspeptic symptoms (flatulence, diarrhea, vomiting), fever with elevated body temperature.

The child is shivering, he sweats a lot, the work of the heart and liver is disrupted. This form of the disease is especially characteristic of young children under one year old.

Salmonellosis in a child may be accompanied by a rash on the body. This form of the disease is called typhoid.

It passes with a clouding of the child's consciousness and a strong fever. Otherwise, the same symptoms are observed as in other forms of the disease.

Complications of the disease are dangerous because bacteria, spreading throughout the body, can form lesions in various organs.

Treatment is complicated and delayed, relapses are possible. The baby's immunity decreases, other concomitant diseases appear.

Possible treatment

If signs of toxicosis occur, it is necessary to provide first aid to the child before the arrival of an ambulance or the arrival of a doctor. For this, the stomach is washed.

Requires two liters clean water room temperature. The procedure can be carried out only if the child is three years old!

Washing consists in the fact that the baby is given a glass of water to drink, then he presses his finger on the root of the tongue, causing vomiting.

If the disease is severe, hospitalization is necessary. Children under the age of 1 year are also sent to the hospital to be treated.

If a sick child lives in a dormitory, he is sent to a hospital for treatment to prevent an epidemic.

For mild forms of the disease, home treatment is possible. The child is assigned complex treatment, which includes enterosorbents to remove toxins, and other drugs.

The diet should consist of boiled, grated foods (table No. 4 according to Pevzner), milk, animal fats and vegetables with coarse fiber are excluded from the diet.

To improve the absorption of food in the inflamed gastrointestinal tract, prescribe enzyme preparations. To replenish the fluid that the body loses, give plenty of water containing glucose-salt solutions to drink.

To restore normal microflora intestines, the doctor may prescribe bifidumbacterin. Treatment includes vitamins and anti-allergic drugs. Antispasmodics are prescribed to relieve pain.

In severe forms of the disease, post-syndromic and infusion therapy is carried out. Antibiotics are prescribed.

Since the disease is accompanied by toxicosis and dehydration, they make droppers, give enterosorbents and probiotics.

Medical diagnostics

If there is a suspicion of Salmonella infection, a visit to the doctor is necessary. Without special tests, the doctor will be able to diagnose an acute intestinal infection.

To determine what was the source of its appearance, what pathogen caused the development of symptoms, the patient is examined. Surrender general analyzes blood and feces, culture tank, special blood test.

After illness

For some time (about a month), the diet after salmonellosis should be gentle for gastrointestinal tract. The child should not eat fried, fatty foods that are heavy on the stomach.

A sick baby is usually put on a dispensary record. Doctors observe him for some time. He takes tests and tank crops.

If the tests show that the child is healthy and is not a carrier of salmonella, he is removed from the register, allowed to attend kindergarten and other collective institutions.

The family of the sick baby and everyone who was in contact with him are observed for seven days. They take an analysis of feces, if bacteria are not detected, they are considered healthy. To determine the source of infection, a study of suspicious food products is carried out.

Prevention measures

To prevent reinfection it is necessary to observe hygiene - to teach the child to wash his hands before eating.

An ill child retains immunity to the disease for six months. Then he can get infected again and get sick.

It is necessary to strengthen the immunity of the child. For this, drugs are immunomodulators, vitamins, probiotics.

It is necessary to pay attention to sufficient physical activity, do exercises with the baby, water procedures, hardening. A strong immune system will children's body resist infection.

Despite the low sensitivity of Salmonella to antibiotics, they die from the action of conventional disinfectants.

Therefore, you need to monitor the cleanliness of the floor in the apartment where the baby lives. Toys also need to be washed every day using washing soap.

It is necessary to limit the contact of the baby with farm and domestic animals that may be carriers of the disease. Swimming in polluted natural water bodies is not allowed during the summer.

If there is a patient with salmonellosis in the house, separate hygiene products and utensils are allocated for him.

Salmonellosis in children in terms of the nature of manifestations does not differ from what is observed in the adult world. Children under one year often develop a septic form. Differences arise at the stage of treatment. We will talk mainly about salmonellosis, to a lesser extent - about children. The disease is caused by bacteria from numerous serotypes. The observed pattern is remarkably similar. This is an acute intestinal infection - poisoning.

Salmonella persists in environment- lies for years in dried excrement. Because mothers say not to take any muck from the floor. Nature has endowed bacilli with little virulence. For the occurrence of a disease, at least 100 thousand units must penetrate into the body. In the case of dysentery, typhoid, much more modest amounts are indicated. Throughout the existence of mankind, immunity to small doses of the causative agent of an infectious disease has developed.

Symptoms of salmonellosis in children are caused mainly by sick animals, poor-quality food. The mechanism of transmission from person to another person is not implemented. The disease is acute, with the appearance of distinguishable symptoms. Medical treatment does not require. Doctors are waiting for the symptoms to pass, they are engaged in the restoration of intestinal microflora. An exception is the generalized nature of the infection (the body suffers).

In the hospital, measures are being taken to combat dehydration. Antibiotics are used for global infection, when internal organs suffer. Komarovsky calls salmonella bloody and writes that pets are sources of infection (cats and dogs). Highest percentage carriers (up to 40) registered among rats.

Doctors do not observe large epidemics. The infection rate is low. People suffer families, apartments. Exceptions in:

Kindergartens.
Schools.
boarding schools.
Medical institutions.

The flares are evenly spaced throughout the year. A weak surge is recorded in the autumn-summer period. Infection occurs through food:

Eggs.
Poultry meat (chickens, turkeys, waterfowl).

Beef and pork are infected in fewer cases. Sources are animals. Water and contact-household ways are rarely implemented. The latter takes place in public institutions - in hospitals, the risk of catching an infection increases.

There is an increase in the incidence of salmonellosis. RF is no exception to the rule. Among children, the frequency of cases is 3 times higher - 1 person per 1000. It's too early to sound the alarm, but it's time to think about the reasons.

The causative agent of the disease

Russian scientists have worked hard - they have compiled a list of bacteria that are more common in the Russian Federation and that cause salmonellosis in a child. Bacilli belong to the genus Salmonella, where the specific name of the disease comes from. Based on the structural features of DNA, physicians distinguish 2 types.

The causative agents are limited to a small number of serovars rarely encountered in practice. The number of serotypes is large - more than 2500. Practical value for doctors they have 10-15. These species account for 90% of cases. The optimal breeding environment is moderately alkaline (pH 7.2 to 7.4), observed in the duodenum, at a temperature of 37 degrees Celsius.

Classification

Much attention has been paid to Salmonella in ICD-10. The disease is classified under section A02, which includes 4 subgroups:

1 - septicemia.
2 - local infection.
8 - other specified infections.
9 - unspecified infection.

The classification of salmonellosis according to clinical signs has not been accepted. The disease proceeds cyclically with characteristic biochemical and bacteriological signs in faeces. Options for the development of events of an atypical picture:

According to the severity of the course, three forms are distinguished: mild, moderate, severe. They differ in flow patterns - according to the type of gastritis, enteritis, colitis. The nature of the course is smooth, non-smooth (with exacerbations and relapses). Conditional division by time:

Up to 1 month - acute.
Up to 3 months - protracted.
Over 3 months - chronic salmonellosis.

Scheme of infection

Sticks of small length (units of microns), equipped with half a dozen pairs of flagella for propulsion. This helps the bacillus to invade:

Adhesion - moving the flagella, the sticks go deep into the mucus, attached to the epithelium. The local immune system in the initial period is completely defenseless.
Invasion is the way of movement in small intestine resembles typhus. Bacteria penetrate into M-cells, infect lymphatic tissues.
Propagation - Bacilli survive inside phagocytes, multiply there. This leads to the spread of the disease throughout the body to a generalized form. Normally, the blood is sterile, infection does not occur.

The power of the wand is in endotoxin, which induces the body to non-standard reactions. This is manifested by fever, the synthesis of cytokines unnecessary for the body. In some places it comes to blood clotting in the vessels. Diarrhea is provoked by cytotoxin. The production of chloride ions is disrupted, sodium is not bound by anything. This leads to the release of water into the intestines.

After the illness, unstable immunity is developed for 3-6 months. Intestinal infection is forgotten by the body. Possible relapse.

Big Picture

Childhood salmonellosis is severe and prolonged. Due to the weakness of the immune system, intoxication is pronounced, epithelial lesions are deep. From time to time, bacteremia develops (a stick in the blood), it reaches toxic-dystrophic, septic forms. In newborns and infants, it disappears when the child reaches three years. A relatively mild course dominates here, up to the development of carriage (without symptoms).

Incubation period absent. The first signs of salmonellosis in children are observed within hours after contact with the infection. The gastrointestinal form manifests itself in a child more often - up to 98% of cases. Other - falls on a more dangerous generalized course with a general poisoning of the body. In 80% of cases there will be signs of an acute intestinal poisoning. In the subacute variant, 1-2 signs are fixed (colic and intoxication), after a couple of days, symptoms of dyspepsia join. Intoxication provokes the manifestation of a number of non-specific symptoms:

Fever.
Chills.
Prostration.
Physical inactivity.
Decreased appetite.

Dyspepsia covers a spectrum of symptoms related to the gastrointestinal tract. In two-thirds of cases, the liver is enlarged. The disease is often accompanied by mucosal inflammation syndromes - gastritis, enteritis, enterocolitis, hemocolitis. The illness lasts from several days to weeks. Clinical features are not used for classification and diagnosis.

Individuals with a deficient immune system are severely affected for obvious reasons.

Descriptive picture by severity

There is no classification according to clinical signs. Doctors have long noticed key points. The severity is determined by changes in the blood and signs present in feces.

Easy

This share of cases in epidemics accounts for up to 40% of those registered. The disease begins with a fever with a temperature of up to 38 degrees Celsius. Intoxication is mild, there is unexpressed pain in the absence of palpation. The chair is liquid, infrequent (up to 5 times a day).

Medium heavy

Fixed in more than half of the cases. With a fever, the temperature rises to 40 degrees Celsius. Accompanied by chills, sweating. Symptoms of intoxication are more pronounced. From the side nervous system- weakness, dizziness. Dyspepsia does not allow to lie still: the frequency of stool increases up to 20 times a day, streaks of mucus and greenery are observed in liquid excrement. Kal characteristic appearance"frog spawn", "rectal spit", "swamp slime". With a colitis variant of the development of diseases, blood is acceptable in places.

Nausea comes to repeated vomiting. Pain in the abdomen becomes cramping in nature (in the umbilical region). Remain up to 10 days, begin - before the appearance of diarrhea.

heavy

The difference is in pronounced symptoms of intoxication of the nervous system. Anxiety, slight tremor hands easily turn into delirium, convulsions occur. The condition develops to a stupor. Functions are broken of cardio-vascular system, internal organs. The increase in the frequency of stool continues, the pain is pronounced. Then the classification is carried out according to the symptoms prevailing in the clinical picture:

The variant with gastritis follows the path of a typical food poisoning. Characteristically: the nature of the stool does not change, signs of dyspepsia, intoxication disappear after a few days.
The gastroenteric variant is characterized by abundant liquid, foamy stool with the addition of blood, mucus. Dehydration of 1-3 degrees is fixed. Cramping pains.
Gastroenterocolitis, enterocolitis are accompanied by abundant stools with impurities of greenery, mucus. Gradually, blood appears in the stools. Characterized by flatulence. On palpation, abdominal distention is observed. The pain persists. A week after the onset of the disease, the liver and spleen increase.
Forms of colitis, hemocolitis are more like dysentery. Tenesmus is practically not observed. This clinical sign to distinguish between infections. Soreness in the area sigmoid colon, with palpation of the site, it is possible to identify tangible tension.

Complications and syndromes

The treatment of salmonellosis in children is aimed at rehydration of the body - replenishment of moisture losses. Because of frequent calls to defecation and vomiting fluid reserves in the body are sharply reduced. More often the syndrome is observed during the course of the disease along the path of enteritis or gastroenteritis.

In two-thirds of cases, the liver is greatly enlarged. Appears by the end of the first week, persists long time. A part of the spleen will enlarge. Diagnosis by outward signs it is impossible to put - the named organs are the first to take the hit of infections.

Doctors call a wide range of conditions:

Renal failure.
Perforation of the intestinal wall.
Neurotoxicosis.
Prolapse of the rectum.
Sepsis.
hypovolemic shock.

Treatment of children

Diagnostics mainly consists in collecting information. At the first stage, they are treated in the usual way. With a local form, antibiotics are not taken, antiseptics may be effective. Diagnostics in pediatrics focuses on:

The presence of dangerous infants allergic reactions for drugs.
The state of the child's psyche.
Threat to life due to third-party causes.

This imposes adjustments when treatment is prescribed. Held differential diagnosis with other diseases. Typical clinical signs:

Violent fever of moderate duration.
Intoxication of the nervous system: lethargy, loss of strength, loss of appetite up to its complete absence.
Invasive, watery, mixed diarrhea.
Mass loss. Thirst, dryness of mucous membranes and skin.
A large fontanel, eyeballs are examined.

The severity is assessed according to the signs:

severity of dehydration.
The degree of damage to the gastrointestinal tract.
Violation of the functions of some organs.
The severity of symptoms characteristic of intestinal infections.
Sepsis.
The presence of infectious-toxic shock.

Today, salmonellosis is allowed to be cured at home (unlike typhoid or dysentery). With inefficiency action taken(within 2 days) hospitalization is carried out. Signs for hospitalization according to the guidelines of the World Gastroenterological Organization:

Mental changes.
Failure of oral rehydration.
Prematurity.
Chronic diseases.
Age up to six months.
Weight up to 8 kg.
Severe fever in newborns - above 38 degrees Celsius, up to three years - above 39.
The presence of blood impurities in the stool.
Severe diarrhea, vomiting.

Attention is paid to living factors. Prevention of the spread of the disease requires the hospitalization of a child from a large family, a shelter.

During hospitalization, they are treated for dehydration, collect toxins with sorbents, and suppress the growth of the strain antimicrobials and by stimulating the immune system. Along the way, they fight fever, abdominal pain (by taking antispasmodics). When the symptoms subside, the Salmonella carrier undergoes procedures to restore the intestinal microflora.

The criteria for recovery are the absence elevated temperature body for more than 2 days, normal stools, no enlargement of the spleen or liver, disappearance of inflammation.

Rehabilitation

A diet is prescribed for the period of treatment. Children from the age of one year are assigned unadapted dairy products. When the child is ill, rehabilitation is carried out.

Events are held in a smooth sequence, showing a single complex.
The duration of the procedures ends at the stage of early convalescence.
Adequacy of measures, taking into account the physical condition, age.
Monitoring the effectiveness of ongoing activities.

After discharge, follow-up with a doctor is carried out according to the recommendations given in the hospital. Estimated general state. The study (in the absence of specialized specialists) is carried out by a pediatrician or therapist.

Salmonellosis is an infectious, deadly disease for children. Not having specific symptoms and manifestations, it can be confused with many other infections. Therefore, knowledge of the ways of transmission and clinical manifestations help to suspect this infection in time and prevent the development of complications.

What is salmonellosis

Salmonellosis is an infectious disease that can occur both with severe symptoms of the disease and be asymptomatic (when carriers are present). The causative agent of this disease is the Salmonella bacterium.

Salmonella is a rod that has a flagellum (an organelle of movement) with which it moves. It is well preserved in the environment; oxygen is not necessary for its vital activity. In water and frozen meat, it can survive and multiply for about six months, in sausages - up to 4 months, in milk - up to three weeks, in cheese - up to a year, in soil - a year and a half.

Reproducing in food (milk, meat), salmonella does not change the taste of the product. Smoking or salting does not have a detrimental effect on microorganisms, and freezing, on the contrary, increases their lifespan.

Salmonella is a bacterium with flagella for locomotion

Once in the body of a child, salmonella infects the intestinal wall, forming foci of reproduction in it. Endotoxins released by the pathogen lead to the release of fluid from the cells of the intestine, which causes diarrhea.

Loss of fluid leads to dehydration, decreased blood pressure which is dangerous hypovolemic shock and death of the patient. In addition, bacterial toxins enter the bloodstream, leading to infectious-toxic shock (fever, weakness, loss of consciousness, infection).

Video of Dr. Komarovsky about the disease

Causes

The source of infection can be animals (large cattle, pigs, horses, ducks, geese, chickens) and their products (milk, eggs, meat). A person becomes infected when eating animal products or when processing affected animal carcasses.

Also, a person who is a carrier of salmonella can become a source of infection. Then this pathogen is transmitted by household contact through household items (towels, dishes, toys), hands, furniture. Especially often this happens in children's groups (schools, kindergartens) when hygiene rules are not observed or in medical institutions for the same reasons.

Raw eggs are one of the most common salmonella-containing foods.

The incubation period of the disease in the food way of transmission is from 6 hours to 3 days (average 12-24 hours). With the contact-household transmission route, incubation is extended to 3–8 days.

Of the group of people who come into contact with the pathogen, not everyone will transfer the disease to severe form. It depends on several factors:

the number of bacteria that have entered the human body;
pathogenicity of the pathogen (the strength of the pathogenic properties of the bacteria that cause the disease);
the immune status of a person (the stronger the immunity, the less likely the occurrence of a severe form of salmonellosis);
age of the patient (newborns and premature babies are more sensitive to the causative agent of salmonellosis).

Symptoms of the disease in children

Clinical manifestations of salmonellosis vary depending on the form of the disease.

Form of the disease		Clinical manifestations (symptoms)
Localized form (gastrointestinal)	Gastritis variant (only the stomach is affected)	nausea; vomit; pain in the epigastrium (upper third of the abdomen).
	Gastroenteric form (affects the stomach and small intestine)	signs of intoxication (fever, headache, weakness, chills); pain in the abdomen (usually spasmodic, localized in the epigastrium or in the navel); nausea; repeated vomiting; diarrhea (watery stools, mixed with foam and greenery, fetid odor); dry skin; increased heart rate (tachycardia); lowering blood pressure; convulsions (in severe cases).
	Gastroenterocolitic form (affects the stomach, small and large intestines)	The symptoms are the same as in the gastroenteric form, but on the 2nd–3rd day of the illness, the number of bowel movements decreases significantly, and impurities of mucus and blood appear in the feces. Tenesmus (false urge to defecate) is characteristic.
Generalized form	Typhoid variant (similar to typhoid fever)	Symptoms of gastroenteritis include: fever; weakness; headache; insomnia; pale skin; rash on the body in the form of "stars"; decrease in blood pressure and heart rate; enlargement of the liver and spleen.
	Septic variant (by type of infection)	It starts with symptoms of gastroenteritis, then join: fever with chills, which is replaced by a sharp sweating with a decrease in body temperature; muscle pain; increased heart rate; bone pain (with the spread of infection and the development of osteomyelitis); joint pain (with the development of arthritis).
	Meningeal form (like meningitis)	convulsions; vomit; headache; tonic muscle tension.

It is important to know that bacteriocarrier does not manifest itself clinically at all, it can be detected only when laboratory examination patient.

The course of the disease in newborns and infants is manifested in a severe form of gastroenteritis with rapid dehydration, convulsions. Often another infection joins salmonellosis, mixed infection develops, in most cases with a fatal outcome.

Diagnostics

When the first symptoms of the disease appear, you should contact a pediatrician or an infectious disease specialist. Salmonellosis, because of it severe complications, it is better to treat in a hospital. To confirm the diagnosis, the following examinations are carried out:

Clinical blood test. Salmonellosis has no specific manifestations in the blood test. There may be an increase in the number of leukocytes, erythrocyte sedimentation rate (ESR), neutrophilia ( a large number of neutrophilic granulocytes in the blood) - all these are signs inflammatory response in organism.
Sowing media for the presence of salmonella. Media can be vomit, feces, urine, blood.
Serological blood tests. Aimed at the detection of antibodies to the pathogen.

Treatment

Mild, so-called subclinical forms of the disease, can be treated at home. Symptoms of gastroenteritis or generalized forms of the disease, especially in infants, are treated only in a hospital!

Gastroenteritis

Gastric lavage. It is performed to remove contaminated food, toxins and bacteria from the stomach.
Antibacterial drugs for this form of salmonellosis are ineffective. Apply antimicrobial agents that do not have a systemic effect (drugs such as Nifuroxazide, Enterofuril). Preparations of this group are allowed for children older than 1 month.
Replenishment of lost fluid and restoration of water-salt balance. For this purpose, they drink drugs for oral rehydration. These include Regidron, Oralit, Biogaya ORS, Glucosolan. At severe course diseases resort to intravenous fluid replacement using solutions such as Trisol, Neogemodez, Reosorbilact, Reopoliglyukin.
Drugs that adsorb toxins. They are used to reduce toxicity. This group includes Smecta, Enterosgel, Sorbeks, Polyphepan.

Generalized forms

It is based on the same groups of drugs as in gastroenteritis, but in combination with antibiotics aimed at destroying salmonella directly.

For a period of intestinal symptoms(vomiting, diarrhea) diet No. 4 according to Pevzner is prescribed. Foods that can chemically or physically damage the wall of the gastrointestinal tract are excluded from the diet. You can’t starve - it can weaken defensive forces organism.

You can not eat foods that increase intestinal motility:

raw vegetables;
fruits;
dairy products;
black bread.

Banned products that enhance fermentation processes:

marinades;
sauerkraut;
fatty food;
sweets.

Prohibited products in the photo

Raw vegetables and fruits

Allowed rice porridge, boiled lean fish, low-fat steamed meats, fruit juices or jelly, low-fat cottage cheese, hard cheese.

Sample menu for the day:

Breakfast - mannik and yogurt.
The second breakfast is low-fat cottage cheese.
Lunch - vegetable puree soup, beef meatballs, tea.
Snack - steamed omelette, jelly.
Dinner - rice pudding, tea.

After the diarrhea stops, the patient is transferred to diet No. 13. This is a diet designed for patients of any infectious disease. Food is served crushed, in the form of mashed potatoes. The list of allowed foods is expanding - you can eat vegetables, fruits, eggs, butter, meat, fish.

Possible menu for the day:

Breakfast - semolina with milk, tea.
Second breakfast - boiled egg, rosehip compote.
Lunch - mashed vegetable soup, steam meatballs, rice porridge, compote.
Snack - a baked apple.
Dinner - boiled fish, mashed potatoes, tea.

This diet should be followed for no more than two weeks.

Possible Complications

Incorrect or untimely treatment of salmonellosis leads to a relapse of the disease, as well as to the development of such consequences as.

Salmonellosis is a worldwide acute intestinal disease, which is caused by salmonella, accompanying intoxication of the body. In terms of the number of recorded cases of morbidity among infections of the large intestine, salmonellosis is in second place. It is slightly inferior to shigellosis.

Causes of salmonellosis in children

The main primary source of Salmonellosis infection is considered to be different domestic animals. It can be cats and dogs familiar to us, Domestic bird, large and small cattle - cows, pigs, sheep, goats. In animals, the disease can be both pronounced (symptomatically) and asymptomatically (that is, in its erased manifestation).

Asymptomatic carriage in animals is more common, so a person often becomes infected with salmonellosis, completely unaware of it. It can communicate with an infected animal - this is a direct route of infection, or it can use food from the composition of an infected animal (for example, sour cream, kefir, dairy products, yogurt, eggs, meat products, cottage cheese) - this is already a cross-mediated infection.

People themselves can be the primary sources of infection. Initially, for only born babies and older children. The child is often infected in public places, in kindergarten or on the playground. Babies during childbirth can become infected from an infected mother who is a carrier of salmonella. Newborns are often even born with salmonellosis, since they can become infected even in the womb of an infected woman.

Fruits and vegetables can get infected during transportation and storage. That's why it's worth washing food before eating, because eating an unwashed apple or tomato increases the risk of contracting salmonella. Salmonellosis in children often "flares up" when sanitary and hygienic standards are violated in children's institutions when preparing food, with improper preservation of food.

Salmonellosis in young children is far from uncommon. Preschool children especially suffer from it, that is, it can be children even 2 years old and 3 years old. This infection often occurs in children under one year old, at 5 years old, at 3 years old, at 1 year old. Household contact method is a key way of infection for young children. Salmonellosis is infected through towels, sheets, staff hands, changing tables, chamber pots, care items. At risk are sickly children with a weak and weakened immune system.

Most often, infection occurs in the summer-autumn period.

Forms of salmonellosis in children

In medicine, it is customary to distinguish various stages of salmonellosis in children. In young children, such an infection occurs in a septic, typhoid-like, gastrointestinal stage. Salmonellosis is also chronic.

The main forms of salmonellosis in children are as follows:

atypical (bacteriocarrier, erased and subclinical);
typical (septic, typhoid and gastrointestinal).

The most widely represented degree is gastrointestinal. In this case, salmonellosis can affect various parts of the gastrointestinal tract and cause other pathologies of the colon and small intestine, For example:

enterocolitis;
colitis;
straighten;
enteritis;
gastroenteritis.

Diagnosis of salmonellosis in a child

Not everyone knows how to understand if a child has salmonellosis? Diagnosis allows you to accurately determine the presence or absence of this disease in a baby.

Standard stages of the disease always begin with acute exacerbations. There is vomiting. Vomiting can be with a rare interval in time, but long enough (depending on the intake of water or food). The child may have a fever for a long time.

Diagnosing salmonellosis, experts initially check the tongue - in case of illness, it is densely lined with white bloom. Also look at meteor manifestations. Look at the iliac region on the right - rumbling sounds and pain in this area. Also, during the diagnosis, doctors check the condition of the stool - what is it like? Enterocolitis, like swamp slime, or enteritis.

When diagnosing, biostudies are also carried out:

serological;
bacteriological.

This helps to make an accurate diagnosis.

The serological method helps to identify antigens in bio-materials, and specific antibodies in plasma. Bacteriological method allows you to study blood, urine, vomit and other human secretions.

Symptoms of salmonellosis in children

Before starting treatment for salmonellosis, you need to understand if the child has signs of this disease.

The incubation period lasts five to six days. Its duration depends on the number of Salmonella that “came” into the body and on the method of infection. Depends on clinical grade external symptoms- its sequence, as it manifests itself.

In older children who have contracted salmonella through food, severe symptom gastroenteritis and gastritis. It is not difficult to detect infection in this case. She has an acute onset: the child has general weakness in the body, high fever and vomiting. The tongue is covered with a thick white coating, it becomes dry. The stomach swells. The stool is also upset - there may still be tight feces, but liquid stool may disappear for several days. There may be a diarrheal syndrome - when the stool happens every three to five days of a liquid or mushy consistency, with pieces of undigested food and impurities of a green mucous mass.

With direct contact with the pathogen, which often happens in children both up to a year and from a year, the enteric form begins. infant often in these cases nausea. He may have frequent stools - up to ten times a day, the latter may be: watery, undigested, copious, liquid. In children at 1 year, at 2 years and at 3 years, tummies swell. On palpation, strong rumbling sounds spread through the intestines. More possible first signs of salmonellosis in this case are a slight rise in body temperature and toxicosis with vomit.

Extraintestinal manifestations of the disease are also possible. For example, a rash on the body. With a typhoid-like stage, the infection can often be confused with paratyphoid. The temperature can rise to 42 degrees. The child loses his appetite, he is tormented by a headache, he may even lose his hearing. Of the symptoms - clouded consciousness, delirium, meningism, white coating in the language.

Treatment of salmonellosis in children

Having identified and established the symptoms of salmonellosis, determining the form of the course of the disease and, accordingly, the incubation period, you can begin treatment. Therapy is selected based on the age of the baby. The accompanying pathological processes and the degree of progression of this infection.

It is quite possible to cure a baby at home, although it is preferable to put the child in infectious hospital in hospital. The patient is shown bed rest, diet food and drug therapy.

The treatment uses not only medical preparations. For example, in the acute stage, a tea-water break of ten hours is attributed (the water temperature should be at room temperature). During such therapy, the patient receives a daily fluid. This helps to avoid dehydration of the body.

At constant vomiting, frequent loose stools and a small amount urine is attributed to solution drip infusion.

Antibiotics are often prescribed for a young child.

Tests for salmonellosis in children

Quite often, moms and dads take salmonellosis for banal poisoning. That is why it makes sense to be tested for salmonellosis. This will allow you to accurately find the cause of the disease and make the correct diagnosis. Only a specialist - a family doctor, an infectious disease specialist, a therapist, a gastroenterologist or a pediatrician - can give a direction for tests, determining which ones the child needs to pass. The doctor will send to the laboratory or to the diagnostic center at the hospital.

As a rule, different environments of internal organs are taken for analysis. This allows you to identify not only the Salmonella themselves, but also to fix their growth in the body.

Usually, tests are given at the manifestation intestinal infections. Also, if you need to differentiate salmonellosis from poisoning, acute cholecystitis, appendicitis, thrombosis, myocardial infarction.

Diet for salmonellosis in children

Nutrition is one of the foundations in the treatment of salmonellosis in a child. In this disease, the water and electrolyte balance, which may have backfire. Therefore, a diet for salmonellosis is important. It should be as soft as possible, because the body needs to be spared. Its goal is to restore normal intestinal microflora, reduce the effect on inflamed intestinal mucosa (mechanical and chemical).

The diet for salmonellosis is mainly protein. The diet is fractional. Food is eaten in five to six meals a day. Be sure to drink small volumes of two to four liters of clean water per day. You can also drink herbal teas.

Products, fermenting, you need to delete from your standard diet. All dairy products are subject to a temporary ban. Also, do not eat grapes, greens, cucumbers, cabbage, legumes during this period. All citrus fruits, pears, beets, radishes, plums are also on the “black list”.

Also, you can not eat:

fast food;
smoked products;
carbonated drinks (especially sweet ones);
sauces and ketchups;
spices;
marinades;
sweet products;
caffeinated drinks (tea and black coffee);
sweet dishes and sweets themselves.

It is recommended to lean on carrots, apples, bananas. It is especially good to make puree gruels from them. You can eat mashed potatoes with water. Cereals are allowed - semolina, buckwheat, rice. But porridge should be on the water and without cream is small. Instead of bread, it is better to take crackers from wholemeal flour.

The diet must be followed for at least three months.

Salmonella medicines for children

The main drugs for salmonellosis are enterofuril and antibiotics. Self-medication with the latter at home is not carried out.

Antibacterial drugs may also be prescribed - for example, in a severe form of the disease. Their reception takes place under the strict supervision of a doctor. Children under three years of age should not be given such medicines.

Sorbents are also used in the treatment. They help to remove toxins and waste products of salmonella from the intestines.

Consequences of salmonellosis in children

The consequences of salmonellosis can be very different. Often, the disease causes complications and continues to remind itself in the form of dysbacteriosis, constipation, diathesis ( skin rashes), disturbed stool.

If the illness was in complex form, the function of internal organs may be impaired. And this, in turn, may cause other serious illnesses such as vascular collapse.

Salmonellosis can exacerbate chronic diseases and turn the disease into a chronic stage.

Often in a child who has had salmonellosis, for a long time otitis media, pneumonia, tonsillitis do not go away. The baby may remain a carrier of bacteria, and this may already lead to the fact that the child will be banned from visiting children's and public places - kindergartens and schools.

Prevention of salmonellosis in children

Infection is easier to prevent than to cure it later. This is why prevention of salmonellosis is important.

It is necessary to strengthen the work of the immune system. With the natural resistance of the body to external infections, it will not be so easy to get infected.

Pathogenic bacteria such as salmonella do not tolerate high temperatures. That is why he builds to process all food products with boiling water, boil them for a long time and boil them. For this reason, the meat is baked and cooked for at least sixty minutes.

Be sure to wash your hands with antibacterial agents (in particular, with soap), do not forget about it after visiting the street, after the toilet, after contact with animals and after eating.

Salmonella can live even in frozen foods. That is why, when defrosting food and dishes, you need to pour boiling water over them. These micro-organisms have a good ability to reproduce in warmth, so food should be stored in the refrigerator.

If there are pets in the house, they should be regularly taken to see a veterinarian in order to timely identify Salmonella pathogens.

Sanitary and hygienic standards should always be maintained in the house, and children should be accustomed to them from childhood.

Salmonella is also the cause of typhoid fever, paratyphoid A, B, C.

Salmonellosis is a fairly common disease in children, as is the carriage of the pathogen itself. In terms of prevalence, it ranks second after shigellosis. Infection is most common in preschool children (65%).

food

The food route of infection includes the consumption of unwashed vegetables, fruits that contain the infection, as well as foods that are not thermally processed enough. In external environment bacteria are resistant, low temperatures are not particularly terrible for them. But high temperatures salmonella kills perfectly.

Salmonellosis bacteria multiply very quickly in food - meat, milk, eggs. They are most active at the end of spring and summer, when there are problems with the safety of food.

Animal

Pets are the main source of salmonellosis in children after food. Their feces, urine, saliva, nasal mucus can contain a large amount of salmonella. As a result of infection from animals, both salmonellosis itself and the carriage of the infection can occur.

Contact household

Also, salmonellosis is transmitted to children by a simple household contact: through the unwashed hands of parents or nannies caring for children, through general use children's pots, toys in kindergarten.

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Symptoms

The first symptoms in children appear quite quickly after infection, since the children's immune system has not yet strengthened. It is especially difficult for children under one year old. The incubation period lasts at least a few hours, a maximum of 3-4 days.

Typical shapes

Gastrointestinal

Gastrointestinal - the most well-known form of salmonellosis in children from one year and older. The harmful bacterium is transmitted from the source and infects different areas gastrointestinal tract. The reason is the infection with food; the incubation period is less than a day.

Gastrointestinal salmonellosis in children is externally manifested through the following signs or symptoms:

pain in the epigastric region;
vomiting with repetition;
temperature increase;
weakness in the whole body;
the presence of a thick coating on the tongue;
bloating;
diarrhea (with gastritis);
liquid greenish stools 3-5 times a day (copious, with parts of undigested food).

typhoid

Symptoms of a typhoid form are as follows:

clouding of consciousness;
rave;
plaque on the tongue;
bloated belly;
temperature rise to 39-40 degrees;
headache;
vomit;
decreased appetite;
decline in activity;
stupor.

Typhoid-like salmonellosis in children has additional symptoms - an increase in the spleen, as well as the child's liver. A rare roseolous rash may also appear. Signs of an intestinal disorder may be absent, but more often the disorder manifests itself from the very beginning of the disease.

If the baby is ill with typhoid-like salmonellosis, a complication may be added: pneumonia or otitis media.

Septic

Septic salmonellosis occurs in newborns, infants, children under one year old, premature babies, in children on artificial nutrition and with weak immune system. Symptoms of the septic form:

increasing temperature retention for 21 to 28 days with strong fluctuations;
the appearance of purulent foci with the prospect of developing purulent meningitis;
pneumonia;
otitis;

Treatment

It is absolutely impossible to treat children on their own, especially up to a year. After all, if the treatment is chosen incorrectly, salmonellosis can lead to lethal outcome. To cure a child, it is imperative to show an infectious disease doctor or a gastroenterologist. He will examine, examine him, according to the results of laboratory tests, appoint necessary treatment including proper nutrition.

In order to make an accurate diagnosis after establishing all the symptoms, bacteriological and serological examination. Studied feces, vomit, urine, blood. It may be necessary to resort to intensive care in order to quickly cure the child.

Treatment includes:

strict diet;
reception medicines(antibiotics and intestinal antiseptics).

Having identified signs of salmonellosis in children, the doctor prescribes treatment based on the age of the child, the level of severity of the condition, given the absence of pathological consequences.

If a child under the age of three has been infected with a bacterium, he must be hospitalized.

Treatment and recovery period depends on the severity of the disease. In severe cases, treatment involves bed rest, covering a period of about 3 weeks, in mild cases - 1-2 weeks until it gets better. With the normalization of temperature and stool, the diet can be slightly softened, nutrition - gradually expanded to a level close to normal. The treatment itself should continue as prescribed by the doctor.

Diet

The diet during the treatment period should contain:

additional drink, fermented milk mixtures;
cereals (wheat, buckwheat);
vegetable puree;
light soups.

The main thing is that the food is varied, rich in vitamins and minerals. A strict diet means complete absence in the diet for a long time:

acute;
fried;
spicy dishes.

Vaccine

Taking medications, antibiotics or intestinal antiseptics, not only diet, can remove salmonellosis, its signs and symptoms. In severe cases, they use "heavy artillery" - antibiotics, in the lungs - antiseptics. Medicines are taken as prescribed by a doctor, it is also worthwhile to read the manufacturer's instructions for age dosages first. The diet will only eliminate the additional burden on the weakened body.

If the baby is a carrier of the bacteria, visible signs and symptoms pathological disease salmonellosis are absent, then salmonellosis should be treated with bacteriophages that destroy harmful bacteria, immune lactoglobulins and various biological products that correct the intestinal microflora.

If salmonellosis is accompanied in children by severe toxicosis, dehydration, a glucose solution is injected through a vein or salt preparations. It is impossible to allow more fluid to come out of the body due to vomiting, diarrhea than it got inside. Fluid balance needs to be replenished regularly.

At home

At home, treatment of salmonellosis is acceptable if, in the opinion of the doctor, such a situation is acceptable. Children are treated for salmonellosis, in addition to the drugs prescribed by the doctor, folk remedies.

Proven Method folk treatment such:

Pour 50 grams of chamomile flowers with a glass of boiling water and boil for 5 minutes. After that, insist for four hours, strain and give the infusion to the baby 100 grams several times a day.

Consequences

The consequences of salmonellosis in schoolchildren make themselves felt by gastric and intestinal inflammation. Then balanced diet and the diet must be continued. If, after a course of treatment, a sample was taken for laboratory research, the result contained signs of the presence of salmonellosis in the body, then treatment should be continued, especially if individual symptoms ailment.

If the result of the laboratory test of the child's tests for salmonellosis is negative, special diet prescribed by the doctor must be observed for a minimum of 90 days.

After antibiotic treatment, there may be consequences such as dysbacteriosis, contributing to constipation or loose stools.

Prevention

Prevention is needed to exclude the carriage of the pathogen and prevent infection of family members with salmonellosis. To prevent children and their parents from getting sick, the necessary prevention is as follows:

If you have pets, regularly show them to the veterinarian.
Thoroughly wash and thermally process food that is planned to be used in cooking.
Maintain high sanitary standards in the house, be sure to accustom children to this.
Teach your children to always wash their hands with soap, preferably household soap, after contact with animals.