American Board of Internal Medicine (ABIM) Certification Practice Exam

In treating diarrhea caused by Salmonella, what is the approach for mild cases?

1. Antibiotics are always required

2. Increased fluid intake

3. No treatment necessary

4. Probiotics for 5 days

The correct answer is: No treatment necessary

In cases of diarrhea caused by Salmonella, particularly when the symptoms are mild, the management typically involves supportive care rather than the use of antimicrobial agents. Mild Salmonella infections often resolve spontaneously without the need for specific medical treatment. The body's immune system can generally handle the infection effectively on its own. For mild cases, the primary focus is on maintaining hydration with increased fluid intake, as dehydration can result from diarrhea. However, in practice, if the diarrhea is mild and the patient is otherwise healthy, the best recommendation is to allow the illness to run its course without additional intervention. This self-limiting nature of mild Salmonella infections means that avoiding unnecessary antibiotic use is crucial to prevent potential side effects and the development of antibiotic resistance, as well as maintaining the normal gut flora. In contrast, antibiotics might be reserved for more severe cases or for individuals at high risk for complications. Probiotics might be considered, but they have not been shown to be essential for mild cases of Salmonella-related diarrhea. Therefore, in the context of mild cases of diarrhea caused by Salmonella, allowing the illness to resolve naturally without treatment is an appropriate course of action.