Non-typhoidal salmonella bacteraemia--an under-recognized feature of AIDS in African adults.

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 Doct

journal_title

Tropical doctor

authors

Kankwatira AM,Mwafulirwa GA,Gordon MA

doi

10.1177/004947550403400404

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

198-200

issue

4

eissn

0049-4755

issn

1758-1133

journal_volume

34

pub_type

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