"Message from a turtle": otitis with Salmonella arizonae in children: Case report

Area of Science:

• Infectious Diseases
• Otolaryngology
• Microbiology

Background:

• Salmonella enterica subsp arizonae is a common reptile gut bacterium, posing a rare zoonotic risk.
• Human infections are infrequent, primarily affecting neonates and immunocompromised individuals with reptile contact.
• This case represents the 20th pediatric Salmonella arizonae infection, the second otitis case, and the first mastoiditis case.

Observation:

• A previously healthy adolescent presented with otitis, complicated by mastoiditis, likely acquired from recreational lake water exposure.
• Audiometric testing revealed a moderate conductive hearing loss of 60 dB.
• Surgical intervention identified a concurrent cholesteatoma.

Findings:

• Standard Salmonella enterica subsp arizonae therapy was administered.
• Surgical management included canal wall up mastoidectomy, attico-antrotomy, posterior tympanotomy, and tympanoplasty.
• Postoperative care involved daily dressing changes and antibiotic lavage, leading to favorable healing.

Implications:

• Successful surgical and antibiotic treatment resulted in significant hearing improvement, with thresholds nearing normal levels within one month.
• This case underscores the importance of considering Salmonella arizonae in rare otitis and mastoiditis presentations, especially with potential reptile or environmental exposure.
• Further epidemiological research is recommended to enhance public health strategies for managing these uncommon zoonotic infections.