Prognosis
Most cases of Salmonella gastroenteritis resolve without antimicrobial therapy in 3 to 7 days. Antibiotics are reserved for patients at high risk for developing more severe disease or extraintestinal involvement. In this group, most cases resolve without complication. Patients with AIDS not receiving antiretroviral therapy are at risk for recurrent infections with Salmonella.
The outcome in most cases of salmonellosis is good, with a mortality <5% in the developed world.[44][45] In the US, the average annual age-adjusted mortality rate is 0.03 per 100,000 person-years, with the highest rates of death in adults aged over 75 years and among those with underlying conditions (e.g., HIV).[122] Invasive disease is associated with higher mortality, particularly in low-income countries, with a 2021 global systematic review finding an overall case fatality rate of 14.7% (9.9% in Europe) among individuals with non-typhoidal salmonella invasive disease.[123]
Chronic carriage of the organism may occur in a minority of cases and is asymptomatic. Carriage can be detected only by screening stool cultures, which is typically not recommended unless local health departments or other similar agencies specifically require this testing.
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