A Rare Case of Salmonella typhi Endocarditis in Pregnancy

Area of Science:

• Infectious Diseases
• Cardiology
• Obstetrics & Gynecology

Background:

• Enteric fever, caused by Salmonella Typhi, is prevalent in developing nations, primarily affecting pediatric and adolescent populations.
• Native valve endocarditis is a serious cardiac infection, and its occurrence during pregnancy presents unique clinical challenges.

Purpose of the Study:

• To report a rare case of Salmonella Typhi endocarditis of a native valve complicating pregnancy.
• To emphasize the diagnostic approach and management of pyrexia of unknown origin in this specific clinical scenario.

Main Methods:

• A pregnant patient presented with symptoms suggestive of acute cholecystitis, leading to cholecystectomy.
• Persistent fever despite source control prompted an investigation for pyrexia of unknown origin, including blood cultures and echocardiography.
• Management involved parenteral antibiotics and close clinical and echocardiographic monitoring.

Main Results:

• The patient was diagnosed with native valve endocarditis, with blood cultures confirming Salmonella Typhi infection.
• Following a 6-week course of parenteral antibiotics and monitoring, the patient showed improvement in systemic symptoms and resolution of cardiac vegetation.
• This case represents an isolated report of Salmonella endocarditis of a native valve complicating pregnancy.

Conclusions:

• Prompt evaluation of pyrexia of unknown origin, thorough clinical examination, and appropriate investigations are crucial for timely diagnosis of rare conditions like Salmonella Typhi endocarditis in pregnancy.
• This case underscores the importance of considering uncommon infections in pregnant patients with persistent febrile illnesses.