Treatment of Salmonella gastroenteritis in infants. The significance of bacteremia.

During 1981, we treated 20 infants, less than 24 months old, for nontyphoid Salmonella (NTSal) gastroenteritis (GE). Blood cultures were obtained in 17 cases, and Salmonella bacteremia was demonstrated in 8 (47%). Of the 13 children 3 to 24 months of age, 7 (54%) had positive blood cultures. One child (8 months old) appeared septic. The patients with bacteremia were treated with parenteral ampicillin. All 20 infants recovered, and no focal infectious complications occurred. The incidence of bacteremia in NTSal GE is highest in children under 2 years of age. Previous reports have shown that the peak incidence occurs among infants less than 3 months of age. An infant with Salmonella bacteremia may be afebrile and show no symptoms of sepsis. In most cases, bacteremia is transient and does not alter the course of NTSal GE, but it may result in life-threatening complications such as septicemia and meningitis. Therefore we believe an infant with NTSal GE under 3 months old should have a blood culture and receive antibiotic treatment.