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Published on: July 29, 2022
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
Abstract:
Salmonella serotypes most often produce gastroenteritis, enteric fever, bacteremia, vascular infection and chronic carrier state. Localized infection may occur at any site after Salmonella bacteremia. Pulmonary involvement due to Salmonella infection is rare. Empyema occurs usually in elderly patients or in patients with underlying diseases such as diabetes mellitus, malignancy, or pulmonary disease. We report the case of an 83-year-old male diabetic patient who presented with fever, productive cough, and difficulty in swallowing. The chest radiographs revealed soft shadowing mild atelactasis and pulmonary abscess on left side. CT-guided aspiration of pus was done. Salmonella enterica serotype typhi was isolated from pus sample. Pleural empyema or abscess usually requires surgical drainage in addition to antimicrobial therapy. After complete course of antimicrobial therapy, the patient improved.
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.
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