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[Pleural effusion infected with Salmonella enteridis]
M Vanzeller1, J M Sapage, T Shiang
1Serviço de Pneumologia A, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia.
Abstract:
The authors describe the case of a 49 year-old caucasian male with left pleural effusion. The etiology of the effusion was exsudative with a preponderance of neutrophils. Ten days after admission and on empirical antibiotic therapy, the patient still had fever and the pleural effusion that became purulent. The thoracic echography and computerized tomography showed a subcapsular splenic abcess. The diagnosis was established by the culture of the pleural effusion and the isolation of Salmonella enteritidis enteritidis serotype. According to the antibiogram, a treatment with cotrimoxazole was established with clinical improvement. A splenectomy was performed.
Insights
A rare case of Salmonella enteritidis infection caused a subcapsular splenic abscess and pleural effusion in a 49-year-old male. Prompt diagnosis and treatment, including antibiotics and splenectomy, led to recovery.
Area of Science:
- Infectious Diseases
- Internal Medicine
- Pulmonology
Background:
- Pleural effusion can arise from various causes, including infections.
- Splenic abscesses are uncommon but serious intra-abdominal infections.
Observation:
- A 49-year-old male presented with left-sided pleural effusion, initially treated empirically with antibiotics without improvement.
- Imaging revealed a subcapsular splenic abscess, with the pleural effusion becoming purulent.
- Pleural fluid culture identified Salmonella enteritidis enteritidis serotype as the causative agent.
Findings:
- Salmonella enteritidis enteritidis serotype was confirmed as the pathogen.
- Antibiogram guided treatment with cotrimoxazole, leading to clinical improvement.
- Surgical intervention with splenectomy was performed.
Implications:
- This case highlights the importance of considering Salmonella enteritidis in unexplained pleural effusions, especially when associated with splenic abscess.
- Early and accurate diagnosis through microbiological cultures is crucial for effective treatment.
- Multimodal treatment including antibiotics and surgery can be successful in managing complex Salmonella infections.