9,15 Preoperative antibiotics, however, fail to improve morbidity or mortality in cases of perforation. 4,11 Multidrug antibiotic therapy combined with aggressive fluid resuscitation results in the lowest postoperative mortality. In summary, the typical case of Salmonella enteritis does not require more than supportive care. In cases of enteritis complicated by perforation, prompt operation is necessary to limit morbidity and mortality. Simple closure of intestinal perforations is not acceptable except in isolated cases with a solitary perforation and minimal peritoneal soilage.
Patient outcome is improved by a directed resection of the segment of perforated intestine.
Postoperative broad-spectrum antibiotic therapy is necessary to treat complicated Salmonella infection and peritonitis from enteric spillage. Summary of an international workshop on typhoid fever. Robbin's Pathologic Basis of Disease, 4th Ed. Twenty-five years of experience in the surgical treatment of perforation of the ileum caused by Salmonella typhi at the General Hospital of Mexico City. Harrison's Internal Medicine, 13th Ed.