Differential diagnosis

A similar clinical picture may be seen in the following circumstances:

• campylobacter infection
• shigellosis
• toxin type food poisoning:
  • Staphylococcus aureus
  • Clostridium perfringens
  • Bacillus cereus (toxin-mediated food poisoning however usually has an onset at less than 6 hours)
• inflammatory bowel disease:
  • it may be difficult to distinguish an acute primary Salmonella colitis from an episode of inflammatory bowel disease
  • inflammatory bowel disease is suggested if bloody diarrhoea persists beyond 2 weeks despite appropriate antibiotic treatment
  • a rectal biopsy with histology may be helpful
  • a trial of steroids may also be appropriate