Salmonella empyema an unusual infection - A case report

Area of Science:

• Infectious Diseases
• Pulmonology
• Internal Medicine

Background:

• Pleuropulmonary Salmonella infections are uncommon and carry a high mortality rate.
• Empyema, a serious infection of the pleural space, can be caused by various pathogens.

Observation:

• An 83-year-old male with uncontrolled hematological disease presented with symptoms suggestive of severe respiratory infection.
• Clinical presentation included fever, productive cough, dyspnea, and right-sided pleuritic pain, with chest imaging revealing a loculated pleural effusion and consolidation.
• Blood tests showed anemia and elevated C-reactive protein, while pleural fluid and blood cultures confirmed Salmonella serotype Enteritidis.

Findings:

• The patient was treated with chest tube drainage and a course of antibiotics, initially ceftriaxone and clindamycin, later switched to ciprofloxacin due to slow improvement.
• Clinical and laboratory parameters improved following the adjustment of antibiotic therapy.
• The patient achieved negative blood cultures and significant radiological improvement after seven weeks of treatment, leading to discharge.

Implications:

• This case demonstrates a successful outcome in a rare and typically lethal condition, emphasizing the importance of prompt diagnosis and tailored antimicrobial therapy.
• Effective management of Salmonella-induced empyema is possible even in immunocompromised patients.
• Highlights the potential for non-typhoidal Salmonella to cause severe pleuropulmonary infections.