急診小醫師https://dictionary.cambridge.org/zht/日誌相簿影音好友名片201810021324Salmonellagastroenteritis沙門氏菌腸胃炎?內科沙門氏菌感染造成的腸胃炎.少於5%會併發菌血症.菌血症之後會進一步造成心內膜炎.感染性動脈瘤.膿瘍.骨髓炎. Complications/invasivedisease—Fewerthan5percentofindividualswithdocumentedSalmonellagastroenteritisdevelopbacteremia[6,10].Bacteremiacanleadtoavarietyofextraintestinalmanifestationssuchasendocarditis,mycoticaneurysm,visceralabscesses,andosteomyelitis[11].Twospecies,Salmonellacholeraesuis[12,13]andSalmonellaheidelberg[14,15],appeartobemoreinvasivethanothers.Inaddition,antibioticresistantstrainsofS.typhimuriumareassociatedwithatwo-tothreefoldincreaseintheriskofbacteremia[10,16]. Incidence—BacteremiaandotherformsofextraintestinalSalmonellainfectionareseriouscomplicationsthatmaynotbesuspectedinthesettingofmildprimaryinfection.Theburdenvariesgeographically.InasystematicreviewthatextrapolatedtheglobalincidenceofinvasivenontyphoidalSalmonellainfectionsbasedon10studies,therewereanestimated49casesper100,000peopleworldwidein2010[2].ThegreatestburdenwasinAfrica,whichhadanestimatedincidenceof227casesper100,000people.Approximately65percentofcasesworldwideareinchildrenyoungerthanfiveyears.Itisestimatedthatperhaps1percentofentericinfectionswithnontyphoidalSalmonellaresultinbacteremia,butthetruerateofbacteremiaisunknown,asmanyprimaryentericinfectionsaremildornotmicrobiologicallydiagnosed.COMPLICATIONSExtraintestinalfocalinfection—Nontyphoidalsalmonellaebacteremiacanprogresstodevelopmentofinfectionatanysite,includingtheurinarytract,lung,pleura,heart,longbones,joints,muscle,andcentralnervoussystem.Afterstoolandblood,urinaryisolatesareencounteredmostfrequently;thesemayreflecturologicabnormalities,bacteremiainthesettingofchronicmedicalillness,and/orretrogradespreadofinfection[21,22].Inacaseseriesof229childrenfromanurbansettinginThailandwithinvasivesalmonellosis,respiratorysymptomsweresurprisinglycommon(inabout25percent)[23].Theseandunderlyinghepatobiliarydiseasewereassociatedwithanincreasedriskoffatality.Salmonellameningitisisararecom