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Salmonella empyema: a review

Insights

Salmonella pleural empyema is a rare but serious condition. This case highlights successful treatment through surgery and antibiotics, alongside a review of similar reported instances.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Microbiology

Background:

  • Pleural empyema is a significant clinical challenge, often requiring aggressive management.
  • Salmonella species, particularly Salmonella enterica serotype Typhimurium, are typically associated with gastrointestinal infections.
  • Disseminated Salmonella infections can manifest in extrapulmonary sites, though pleural involvement is uncommon.

Observation:

  • A 35-year-old male presented with a prolonged three-month illness culminating in salmonella pleural empyema.
  • Cultures of the empyema fluid confirmed the presence of Salmonella enterica serotype Typhimurium (S. enterica serotype Typhimurium).

Findings:

  • The patient achieved a cure following surgical decortication and obliteration of the pleural space.
  • Parenteral chloramphenicol therapy was administered as part of the treatment regimen.
  • A review of existing literature identified eight previously reported cases of salmonella empyema, suggesting its rarity.

Implications:

  • This case underscores the importance of considering Salmonella in the differential diagnosis of bacterial pleural empyema, even in the absence of typical gastrointestinal symptoms.
  • Combined surgical intervention and appropriate antibiotic therapy, such as chloramphenicol, appear effective in managing this severe infection.
  • Further investigation into the pathogenesis and optimal management strategies for Salmonella-induced pleural empyema is warranted.

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