Abstract:
:Non-typhoidal salmonella (NTS) infections are severe, invasive and recurrent in the HIV-infected adult, and NTS are the commonest cause of hospital admission with bacteraemia in sub-Saharan Africa. NTS bacteraemia typically presents in patients with HIV/AIDS once the CD4 count falls below 200 cells/microL. In-patient mortality is 35%-60%, and is highest in patients with confusion or severe anaemia. Among survivors, 25%-45% may have single or multiple recurrences of NTS bacteraemia 1-6 months after the first illness, requiring retreatment. Diagnosis relies on blood culture, so in many areas this disease cannot be definitively diagnosed, and must be empirically treated. Treatment is guided by local antibiotic sensitivities; fluoroquinolones are particularly useful for initial treatment if there is multidrug reistance to other agents, and may result in lower recurrence rates than other agents. Where possible, long-term secondary chemoprophylaxis to prevent recurrence is advisable. Successful ARV treatment also prevents recurrence. There is inadequate knowledge about the epidemiology of carriage and transmission among at-risk populations.
journal_name
Trop Doctjournal_title
Tropical doctorauthors
Kankwatira AM,Mwafulirwa GA,Gordon MAdoi
10.1177/004947550403400404subject
Has Abstractpub_date
2004-10-01 00:00:00pages
198-200issue
4eissn
0049-4755issn
1758-1133journal_volume
34pub_type
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