Acute suppurative salmonella thyroiditis: clinical course and antibody response

A previously healthy 72-year-old man, who had been treated with steroids for one month on a presumptive diagnosis of polymyalgia rheumatica, developed a suppurative thyreoiditis. Salmonella enteritidis was isolated from the thyroid aspirate. Although the bacterial strain was sensitive to ampicillin in vitro, the disease was not cured until treatment with trimethoprim-sulfamethoxazole was initiated. The patient developed a high antibody response of the IgM class against both salmonella serogroup B and D O-antigenic determinants, as estimated by enzyme-linked immunosorbent assay (ELISA). Absorption studies suggested that most of the antibody response was directed against salmonella 012 determinant(s), common to both salmonella serogroup B and D.