Salmonella bacteraemia among young children at a rural hospital in western Zaire.

An analysis of 206 cases of extra-intestinal Salmonella infection among children up to 60 months of age admitted to a rural hospital in western Zaire was undertaken. Most children presented with fever but without any focus of infection which was difficult to distinguish clinically from falciparum malaria. The majority (83%) of the infections were due to serotypes other than S. typhi. Infection with these serotypes was clinically indistinguishable from S. Typhi infection and was associated with a comparably high case fatality rate of 23%. Death was significantly associated with age under 6 months (relative risk 1.7), meningitis (RR 4.7), jaundice (RR 2.5), severe anaemia (RR 1.8), contracting disease in the late wet season when malnutrition peaks (RR 2.6) and infection with a chloramphenicol-resistant isolate (RR 3.2). The increasing prevalence of antibiotic resistance and HIV infection will complicate the management of this disease in the future.