Salmonella-induced pericarditis

Salmonella-induced pericarditis (SIP) is a rare complication of Salmonella infection, with only 30 cases reported to date, and a mortality rate of 14.8%. It is mostly associated with immunosuppression and can result in complications such as pericardial effusion, cardiac tamponade, and myopericarditis.

A 58-year-old man complained of chest pain, cold sweats, shortness of breath, cough, and a history of fever. Physical and supporting examinations including echocardiography and pericardial fluid culture were positive for Salmonella based on VITEK 2 Biomerieux. Based on antibiotic sensitivity testing for therapy selection, the patient received 2 grams of ceftriaxone via intravenous (IV) every 24 hours which was then maximized to 2 grams every 12 hours. Outpatient management was planned after confirming the amount of pericardial fluid, last culture results, and clinical improvement.

SIP is very rare. These infections are caused by direct spread from intrathoracic foci or hematogenous spread from other sites of infection, including cross-reactivity of infectious antigens with the body`s antigens, and/or the presence of infection stimulating host immune reactions. Antimicrobials such as fluoroquinolones and third-generation cephalosporins can be given for 4-6 weeks, especially in immunocompromised individuals or those with spread to extra-intestinal sites.

SIP in adult patients with comorbidities and immunocompromised are associated with high morbidity and mortality. Early diagnosis, rational antibiotic therapy, and appropriate surgery provide good prognosis for patients.