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Characterizing Salmonella Typhimurium-induced Septic Peritonitis in Mice
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Spontaneous bacterial peritonitis from Salmonella: an unusual bacterium with unusual presentation

Harshal Rajekar1, Chun-Tao Wai, Kang-Hoe Lee

  • 1Asian Center for Liver Diseases and Transplantation, Gleneagles Hospital Annexe Block #02-37, 6A Napier Road, Singapore, Singapore, 258500.

Hepatology International
|August 12, 2009
PubMed

Insights

Salmonella can cause spontaneous bacterial peritonitis (SBP) in advanced cirrhosis patients, presenting atypically. Early recognition in immunosuppressed individuals is crucial for timely diagnosis and treatment.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Oncology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a frequent complication in patients with advanced cirrhosis and portal hypertension.
  • Commonly, SBP is caused by gram-negative rods and Enterococcus species.
  • Salmonella is an uncommon but recognized cause of SBP, often presenting atypically.

Purpose of the Study:

  • To report a case of Salmonella SBP in an immunocompromised patient with decompensated cirrhosis.
  • To highlight the atypical clinical presentation of Salmonella SBP.
  • To emphasize the importance of considering Salmonella in the differential diagnosis of SBP, particularly in immunosuppressed cirrhotic patients.

Main Methods:

  • Case report of a patient with decompensated cryptogenic cirrhosis, non-Hodgkin lymphoma, and rituximab treatment.
  • Ascitic fluid analysis and culture for diagnosis.
  • Clinical and laboratory data review.

Main Results:

  • The patient presented with Salmonella SBP, an atypical manifestation.
  • The presentation lacked the typical neutroascitic response, potentially delaying diagnosis.
  • The patient had multiple risk factors including cirrhosis, immunosuppression from lymphoma, and rituximab therapy.

Conclusions:

  • Salmonella SBP can occur in cirrhotic patients, especially those who are immunosuppressed.
  • Atypical presentations of Salmonella SBP may include a lack of typical inflammatory markers in ascitic fluid.
  • Physicians must maintain a high index of suspicion for Salmonella SBP in at-risk populations.

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