Pleural empyema due to Salmonella typhi

Faisal Iqbal Afridi1, Badar Jahan Farooqi, Arif Hussain

  • 1Department of Microbiology, Dr. Ziauddin University Hospital, North Nazimabad Campus, Karachi. afridi03@hotmail.com

Insights

Salmonella typhi, a rare cause of lung abscess and empyema, was identified in an elderly diabetic patient. Prompt antimicrobial therapy led to the patient's recovery, highlighting the importance of considering Salmonella in pulmonary infections.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Microbiology

Background:

  • Salmonella serotypes commonly cause gastroenteritis and bacteremia.
  • Pulmonary involvement, including empyema and lung abscess, is a rare manifestation of Salmonella infection.
  • These infections typically affect elderly individuals or those with comorbidities like diabetes mellitus.

Observation:

  • An 83-year-old male diabetic patient presented with symptoms of fever, productive cough, and dysphagia.
  • Chest imaging revealed a left-sided pulmonary abscess with mild atelectasis.
  • CT-guided aspiration of the abscess yielded Salmonella enterica serotype typhi.

Findings:

  • The isolated pathogen was Salmonella enterica serotype typhi.
  • The patient received antimicrobial therapy for the pulmonary abscess and empyema.
  • Successful treatment with antimicrobial therapy resulted in clinical improvement.

Implications:

  • This case underscores the importance of considering Salmonella typhi in the differential diagnosis of pulmonary abscesses and empyema, particularly in immunocompromised or elderly patients.
  • Early diagnosis and appropriate antimicrobial treatment are crucial for favorable outcomes.
  • Further research may elucidate the specific mechanisms of Salmonella translocation to the pulmonary system.

Related Concept Videos

Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
Pleural Effusion I: Introduction01:25

Pleural Effusion I: Introduction

Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
Pneumonia I: Introduction01:29

Pneumonia I: Introduction

Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...
Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pulmonary Tuberculosis III01:31

Pulmonary Tuberculosis III

Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
Pleural Disorders: Types and Brief Description01:30

Pleural Disorders: Types and Brief Description

The pleura is a vital part of the respiratory system. It's a double-layered membrane surrounding the lungs and lining the chest cavity. The two layers of the pleura are: