Merck Manual

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Staphylococcal Food Poisoning


Jonathan Gotfried

, MD, Lewis Katz School of Medicine at Temple University

Reviewed/Revised Jun 2023

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.

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. Nausea and vomiting with abdominal cramps are most common. Diarrhea usually occurs. The symptoms usually resolve within 1 day.

A similar manifestation can be seen in Bacillus cereus infection, typically after consumption of reheated or fried rice.

Diagnosis of Staphylococcal Food Poisoning

  • Clinical evaluation

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.

Treatment with an antiemetic (eg, prochlorperazine, ondansetron) may be helpful, especially in patients who cannot tolerate adequate oral rehydration because of nausea and vomiting.

Drugs Mentioned In This Article

Drug Name Select Trade
Compazine, Compazine Rectal, Compazine Solution, Compazine Syrup, Compro
Zofran, Zofran in Dextrose, Zofran ODT, Zofran Solution, Zuplenz
NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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