Nontyphoidal Salmonella Bacteremia in Previously Healthy Children: Analysis of 199 Episodes

BACKGROUND:Nontyphoidal Salmonella (NTS) bacteremia is not rare in otherwise healthy children in Taiwan. Few studies described the clinical manifestations and outcomes of NTS bacteremia in previously healthy children. METHODS:Children with blood culture positive for NTS treated at Chang Gung Children’s Hospital between May 1996 and June 2003 were identified from the microbiology logbook. Patients who had underlying events or concomitant diseases were excluded. RESULTS:We evaluated 199 patients. One hundred and eighteen (59.3%) were male children and 184 (92.5%) were between 3 months and 5 years of age. Fever (97.0%) and diarrhea (79.9%) were the most common initial presentations. Leukocytosis (leukocyte >15,000/mm) and elevated serum C-reactive protein concentration (≥10 mg/L) were present in 14.6% and 79.4% of the patients, respectively. Eighty-three percent of 184 patients with antibiotic treatment received a third- or fourth-generation cephalosporin as definitive antibiotic therapy. Focal suppurative infections were present in 5 children (2.5%) on initial evaluation, and included meningitis in 2 and osteomyelitis in 3. Neither metastatic complications nor clinically recurrent diseases were found during a follow-up period of at least 12 months after treatment. No fatalities occurred in this series. CONCLUSIONS:In healthy children, NTS bacteremia was relatively benign and extraintestinal focal suppurative infections were infrequently seen. Less than 10 days of appropriate antibiotic treatment is probably adequate for those without a suppurative focus of infection.