An Intriguing Case of Non-typhoidal Salmonella Presenting as Bacteremia and Bilateral Cellulitis in a Diabetic...

Non-typhoidal Salmonella typically presents acutely with gastrointestinal disease/illness. These infections infrequently manifest outside the intestines, often due to bacterial translocation from the gut. However, it is exceedingly rare for it to present as cellulitis, especially in a bilateral distribution. A 35-year-old male with a past medical history of diffuse adiposity, essential hypertension, peripheral neuropathy, and depression presented to the emergency department (ED) for evaluation of sudden onset bilateral lower extremity swelling, pain, and redness. The patient first noted these symptoms upon awakening two days prior, accompanied by night sweats. He mentioned having burned his right medial lower leg on a motorcycle exhaust pipe a week earlier but reported appropriate healing of the burn. Of note, the patient owned a corn snake, a potential vector for Salmonella, and was diagnosed with diabetes during this admission. He was ultimately found to have diffuse cellulitis of his bilateral lower extremities, with subsequent blood cultures yielding a diagnosis of bacteremia secondary to salmonellosis.