Compare non-typhoidal Salmonella and Salmonella Typhi in terms of clinical presentation and disease course.

• A. Non-typhoidal Salmonella causes self-limited gastroenteritis with fever and diarrhea; Typhi causes typhoid fever with prolonged fever, bacteremia, abdominal symptoms, and rose spots.
• B. Non-typhoidal Salmonella causes typhoid; Typhi causes self-limited gastroenteritis.
• C. Both cause identical disease.
• D. Typhi only causes diarrhea.

Answer: (A)

Distinguishing non-typhoidal Salmonella from Salmonella Typhi comes down to how they present and how the illness runs its course. Non-typhoidal Salmonella typically causes acute gastroenteritis after ingesting contaminated food. The illness is usually self-limited, with fever and diarrhea (often with abdominal cramps), and sometimes vomiting. Systemic spread is uncommon, so most people recover without antibiotics within a few days.

Salmonella Typhi, on the other hand, leads to typhoid fever, a more invasive and longer-lasting illness. It has a longer incubation and presents with prolonged fever, malaise, abdominal pain, and sometimes constipation before diarrhea. Bacteremia is common, and patients can have hepatosplenomegaly and distinctive rose-colored spots on the abdomen or chest. Complications can include intestinal hemorrhage or perforation, and chronic gallbladder carriage can occur.

So the correct description is that non-typhoidal Salmonella causes self-limited gastroenteritis with fever and diarrhea, while Salmonella Typhi causes typhoid fever with prolonged fever, bacteremia, abdominal symptoms, and rose spots. The other options mix up this spectrum or state that Typhi is limited to diarrhea, which isn’t accurate.