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[Salmonella dublin enteric fever in two compromised hosts]
Abstract:
Salmonella (S) dublin is a rare cause of human enteric fever. We studied 2 compromised hosts, one of them being treated for lymphocytic leukemia and the other for chronic lymphocytic leukemia. Both had recurrent enteric fever caused by S. dublin. Both strains were resistant to chloramphenicol and to ampicillin and the patients were treated by trimethoprim-sulfamethoxazole to which the organism was sensitive. Investigations failed to discover an extraintestinal localisation and stool cultures remained negative after antibiotic treatment. One patient had a relapse of enteric fever at every relapse of his leukemia; the second patient after his second episode of enteric fever was treated prophylactically during 3 months. When he stopped antibiotic prophylaxis a fatal S. dublin septicemia occurred. We suggest that compromised hosts with S. dublin infection be treated prophylactically to prevent relapse.
Insights
Salmonella dublin rarely causes human enteric fever. In immunocompromised patients, prophylactic antibiotics may prevent fatal relapses of Salmonella dublin infection.
Area of Science:
- Infectious Diseases
- Immunology
Background:
- Salmonella (S) dublin is an uncommon cause of human enteric fever.
- Immunocompromised individuals are at higher risk for severe infections.
Observation:
- Two patients with compromised immune systems (one with leukemia, one with chronic lymphocytic leukemia) experienced recurrent Salmonella dublin enteric fever.
- The Salmonella dublin strains were resistant to chloramphenicol and ampicillin but sensitive to trimethoprim-sulfamethoxazole.
Findings:
- Despite antibiotic treatment and negative stool cultures, one patient relapsed with enteric fever during each leukemia relapse.
- The second patient developed fatal Salmonella dublin septicemia after discontinuing 3 months of prophylactic antibiotics.
Implications:
- Prophylactic antibiotic treatment is suggested for immunocompromised patients with Salmonella dublin infection to prevent recurrent episodes and potentially fatal septicemia.
- This highlights the importance of sustained antimicrobial therapy in managing invasive Salmonella infections in vulnerable populations.