From Gut to Heart: Extensively Drug-resistant Salmonella typhi with Multi System Involvement

Area of Science:

• Infectious Diseases
• Microbiology
• Cardiology

Background:

• Salmonella Typhi is a Gram-negative bacillus transmitted via the feco-oral route, causing enteric fever.
• Untreated enteric fever has high morbidity and mortality, with potential for severe extra-intestinal complications.
• Extensively drug-resistant (XDR) strains pose a significant global health challenge.

Observation:

• A young girl presented with a week of fever, rigors, abdominal pain, diarrhea, nausea, and anorexia.
• She rapidly developed toxic myocarditis, pulmonary edema, septic shock, and coagulopathy.
• Blood cultures identified multi-drug-resistant (MDR) Salmonella Typhi.

Findings:

• The case highlights severe systemic manifestations of XDR Salmonella Typhi infection.
• Toxic myocarditis, pulmonary edema, septic shock, and coagulopathy were critical complications.
• Isolation of MDR Salmonella Typhi confirmed the causative agent.

Implications:

• This case underscores the critical need for early diagnosis and aggressive management of XDR Salmonella Typhi infections.
• Effective intravenous antibiotic therapy can lead to complete recovery even in severe cases.
• Highlights the growing threat of antimicrobial resistance in Salmonella Typhi and its potential for severe outcomes.