Non-typhoidal Salmonella empyema in an immunocompromised patient

Non-typhoidal Salmonella infections commonly manifest as enterocolitis, bacteremia, osteomyelitis, and meningitis. However, pleural involvement is rare. Our patient was a 65-year-old immunocompromised male with alcoholic cirrhosis. He presented with shortness of breath for five days and was found to have a large loculated pleural effusion on imaging. The patient underwent surgical decortication and was found to have exudative pleural fluid with pleural fluid cultures eventually growing Salmonella. The patient was treated with a prolonged course of intravenous antibiotic therapy. This case highlights the necessity of including Salmonella infection in the differential diagnosis of exudative pleural effusions, particularly in patients with aspiration risk and underlying immunosuppressive conditions.