Gastroenteritis

Gastroenteritis is an acute infection of the gastrointestinal tract caused by various pathogens, presenting with diarrhea and/or vomiting, often accompanied by fever, abdominal pain, and systemic symptoms. Nontyphoidal Salmonella is a common cause, leading to an incubation period of 6–72 hours (mean 24 hours), followed by abrupt onset of nausea, vomiting, cramping abdominal pain, and watery or bloody diarrhea. Fever occurs in about 70% of cases, with abdominal tenderness and fecal leukocytes or occult blood. Mild leukocytosis with a left shift is typical. Symptoms usually resolve within a week in healthy children, but may persist for weeks in neonates, young infants, and immunocompromised individuals, including those with AIDS, where disseminated infection, shock, and death may occur. In patients with inflammatory bowel disease, particularly active ulcerative colitis, Salmonella infection can lead to severe complications such as bowel wall invasion, toxic megacolon, and systemic toxicity. Reactive arthritis, associated with HLA-B27, develops in 2% of cases, mainly in adolescents and adults. Fecal shedding of Salmonella can continue for a median of 7 weeks after symptom resolution, especially prolonged in children under 5 years of age.