Snapshot A 20-year-old student presents to the college health clinic for evaluation of vomiting and diarrhea. He had recently seen an ad for a new fad diet - the raw egg diet for body-building purposes. For the past 2 days, he has had a raw egg with each meal. However, today he started having abdominal cramping, nonbloody and nonbilious vomiting, and diarrhea with some blood in it. On physical exam, his abdomen is soft and nondistended and somewhat tender to palpation. His mucous membranes are dry. Introduction Classification non-typhoidal Salmonella spp. most commonly S. enteritidis motile, non-lactose fermenting gram-negative rods an endotoxin-producing bacteria transmission via consumption of contaminated foods causes enterocolitis Epidemiology incidence a common cause of diarrhea in the US demographics all ages risk factors eating poultry, particularly if undercooked or raw reptile pets (turtles) Pathogenesis inactivated by gastric acids, so a large inoculum is required Vi antigen blocks antibody attack on O antigen invades mucosa in the ileocecum Prognosis typically self-limited Presentation Symptoms nausea and vomiting diarrhea may be bloody abdominal pain myalgia Physical exam fever Studies Labs culture of blood or stool Making the diagnosis based on clinical presentation and laboratory studies Differential Salmonella typhi infection distinguishing factors patients typically present with a pink macular rash associated with typhoid fever Treatment Management approach antibiotics are typically not indicated have actually been shown to prolong the duration of disease Conservative supportive care indication all patients modalities hydration correction of any electrolyte imbalances Complications Shock