Staphylococcal food poisoning is due to a preformed toxin made by Staphylococcus aureus bacteria that have contaminated food. Symptoms of nausea and vomiting with abdominal cramps are typically of rapid onset, usually within several hours of ingestion. Diagnosis is clinical. Treatment is supportive with fluids.
S. aureus is commonly present on skin and can enter food if food handlers do not wash properly before touching food. If the food is then left at room temperature, the bacteria can multiply and produce toxin. Food contaminated with Staphylococcus toxin may not smell bad or look spoiled.
(See also Overview of Gastroenteritis.)
Symptoms and Signs of Staphylococcal Food Poisoning
Symptoms of staphylococcal food poisoning begin rapidly after ingestion of contaminated food because they are caused by a preformed enterotoxin present in the food. The symptoms typically begin 30 minutes to 8 hours after eating the contaminated food. Common foods implicated in S. aureus infection include meats/poultry, dairy products, and eggs. Nausea and vomiting with abdominal cramps are most common. Diarrhea usually occurs. The symptoms usually resolve within 1 day.
A similar manifestation can occur in Bacillus cereus infection, typically after consumption of reheated food such as rice that was initially cooled or stored improperly.
Diagnosis of Staphylococcal Food Poisoning
History and physical examination alone
The diagnosis is almost always made clinically based on the onset of typical symptoms shortly after eating a potentially contaminated food (eg, restaurant meal).
Treatment of Staphylococcal Food Poisoning
Oral or IV fluids
Sometimes antiemetics
Supportive care, including rehydration with fluids and electrolytes, is the mainstay of treatment and is all that is needed for most adults. Antibiotics are not indicated.
Oral glucose-electrolyte solutions, broth, or bouillon may prevent dehydration or treat mild dehydration. Isotonic IV fluids such as Ringer’s lactate and normal saline solution should be given when there is severe dehydration (see Rehydration).
Treatment with an antiemetic (eg, ondansetron) may be helpful, especially in patients who cannot tolerate adequate oral rehydration because of nausea and vomiting.Treatment with an antiemetic (eg, ondansetron) may be helpful, especially in patients who cannot tolerate adequate oral rehydration because of nausea and vomiting.
