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Non-typhoidal salmonellosis presenting as acute calculus cholecystitis
Fatema Juma1, Joshua J Cave2, Hector Gonzales2
1London North West University Healthcare NHS Trust , Harrow, UK.
BMJ Case Reports
|July 22, 2019
Summary
Non-typhoidal Salmonella spp. can cause rare gallbladder infections, leading to acute calculus cholecystitis. Early diagnosis and surgical intervention are crucial for managing these unusual infections.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Surgical Pathology
Background:
- Non-typhoidal Salmonella species typically cause gastroenteritis.
- Gallbladder carriage of Salmonella is a less common sequela.
- Acute calculus cholecystitis is an inflammation of the gallbladder associated with gallstones.
Observation:
- A rare case of non-typhoidal Salmonella infection presenting as acute calculus cholecystitis in an adult is described.
- Salmonella enterica subsp. Salamae (ST P4271) was isolated from cholecystostomy fluid.
- The patient's gallbladder exhibited a necrotic fundus following laparoscopic cholecystectomy.
Findings:
- The study highlights a rare clinical presentation of non-typhoidal Salmonella infection.
- Microbiological analysis of bile is essential for identifying pathogens and their antimicrobial resistance.
- Necrotic gallbladder necessitates consideration of early surgical management.
Implications:
- Clinicians should consider Salmonella in the differential diagnosis of acute cholecystitis, especially with a travel history.
- Bile sampling is critical for accurate diagnosis and targeted antimicrobial therapy.
- Early cholecystectomy should be strongly considered in cases of Salmonella-induced necrotic cholecystitis.
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