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Published on: September 22, 2019
Salmonellosis-Induced Pericarditis and Pericardial Effusion: A Case Report and Literature Review
Talal Aloreibi1, Emad Bukhari2, Yazeed Terkawi3
1Infectious Diseases, Al Hammadi Hospital, Riyadh, SAU.
Abstract:
While salmonellosis is commonly thought to predominantly impact the gastrointestinal system, bacteremia and localized extraintestinal infections such as meningitis, empyema, and pericarditis can develop, particularly in immunocompromised individuals. Here, we present a case of a 69-year-old with multiple comorbidities, who presented to the emergency department with dyspnea and hemodynamics instability in the form of hypoxia and hypotension and was found to have moderate pericardial effusion without echocardiographic signs of tamponade. The ischemic workup was unrevealing, and further infectious workups, including pericardial tissue biopsy and pericardial fluid culture, showed growth in Salmonella groups C and D. Subsequently, the patient was diagnosed with Salmonella-induced pericarditis and pericardial effusion and discharged home on oral antibiotics following pericardiocentesis and hemodynamics stabilization. Invasive infections caused by non-typhoidal Salmonella are becoming more prevalent in immunocompromised individuals. Acute bacterial myopericarditis is uncommon in advanced nations, yet it can be life-threatening if not treated promptly. Therefore, a high index of suspicion, early detection, and aggressive invasive and non-invasive therapies would strongly be considered to achieve a desirable outcome and good prognosis.
Insights
Salmonella infection can cause serious heart inflammation (pericarditis) and fluid buildup, even in older adults. Prompt diagnosis and treatment are crucial for recovery from this rare but dangerous condition.
Area of Science:
- Infectious Diseases
- Cardiology
- Internal Medicine
Background:
- Salmonellosis typically affects the gastrointestinal tract but can lead to invasive extraintestinal infections, especially in immunocompromised patients.
- Bacterial myopericarditis is a rare but potentially life-threatening condition that requires prompt recognition and management.
Observation:
- A 69-year-old patient with comorbidities presented with dyspnea, hypoxia, and hypotension, found to have a pericardial effusion.
- Infectious workup, including pericardial biopsy and fluid culture, identified Salmonella groups C and D.
- The patient was diagnosed with Salmonella-induced pericarditis and pericardial effusion.
Findings:
- Successful treatment involved pericardiocentesis, hemodynamic stabilization, and oral antibiotics.
- The case highlights the increasing prevalence of invasive non-typhoidal Salmonella infections in immunocompromised individuals.
- Salmonella pericarditis, though uncommon, can be a severe manifestation of invasive salmonellosis.
Implications:
- A high index of suspicion for invasive Salmonella infections is warranted in patients with unexplained pericarditis, particularly those who are immunocompromised.
- Early diagnosis and aggressive treatment, combining invasive and non-invasive therapies, are essential for favorable outcomes in Salmonella-induced pericarditis.
- This case underscores the importance of considering non-gastrointestinal manifestations of Salmonella infections.
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