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[Salmonella typhimurium as the causal agent of pulmonary cavitations]
P Saballs1, S Aregall, E Pallarés
1Servicio de Enfermedades Infecciosas, Hospital del Mar, Facultad de Medicina, Universidad Autónoma, Barcelona.
Background:
Relation between patients with immunosuppression (malignancy, renal transplant) and bacteremia by Salmonella non-typhi, specially by Salmonella typhimurium, is known. This relation has been published for patients who suffer from AIDS, and so Salmonella bacteremia could even begin the clinical disease. But even though the relation between the infection by Salmonella and AIDS is well known, and the pulmonary involvement in them has been told, this etiology as a producing agent of lung cavitation has not much documentation.
Methods:
We examined three patients (two women and one man) suffering from fever of one week of duration, cough, expectoration and thoracic pain in two of them. The third patient had fever and cachexia without clinical symptoms. The man and the two women had a blood count with neutrophilia and leucocytosis in two cases and leucopenia in the other one. All of them suffered a very important depression of cell immunity (CD4 of 140, 70 and 4, respectively) and positive blood cultures for Salmonella typhimurium.
Results:
Chest X-Ray showed, in all the cases, pulmonary cavities.
Conclusions:
Salmonella typhimurium must be included among the agents that can produce pulmonary cavities like Staphylococcus aureus, mycobacteria, fungus and other gram-negative bacilli.
Insights
Salmonella typhimurium can cause lung cavitation in immunocompromised patients, particularly those with advanced HIV/AIDS. This study highlights a rare but serious complication of Salmonella infection, emphasizing the need for broader differential diagnoses.
Area of Science:
- Infectious Diseases
- Pulmonology
- Immunology
Background:
- Salmonella non-typhi bacteremia is known in immunosuppressed individuals, including those with HIV/AIDS.
- Pulmonary involvement by Salmonella is documented in AIDS patients, but its role in lung cavitation is underreported.
Purpose of the Study:
- To investigate the potential of Salmonella typhimurium as a cause of pulmonary cavities in severely immunocompromised patients.
Main Methods:
- Case series examining three patients with fever, cough, and severe immunosuppression (CD4 counts < 150).
- Diagnostic methods included blood counts, chest X-rays, and blood cultures.
- All patients presented with positive blood cultures for Salmonella typhimurium.
Main Results:
- All three patients exhibited pulmonary cavities on chest X-ray.
- Clinical presentations varied, including fever, cough, thoracic pain, and cachexia.
Conclusions:
- Salmonella typhimurium should be recognized as an infectious agent capable of causing pulmonary cavities.
- This finding expands the differential diagnosis for lung cavitation, alongside bacteria like Staphylococcus aureus, mycobacteria, fungi, and other gram-negative bacilli.