Atypical Multidrug-Resistant Salmonella paratyphi B Infection in a Patient with Uncontrolled Diabetes Mellitus: A Case Report

Abstract

Atypical Salmonella infection usually presents with unusual symptoms in addition to gastroenteritis. Such atypical presentations can pose a challenge for diagnosis and treatment as they may be misdiagnosed, leading to delayed care and potential complications. Here we report an unusual case of Salmonella spp. isolated from a wound swab. A 57-year-old male patient with a history of uncontrolled type 2 diabetes presented to the general surgery department with a 25-day history of swelling, ulceration, and purulent discharge on his right foot. A wound swab was collected for culture and sensitivity. Gram staining showed occasional pus cells and a few gram-negative bacilli. Culture was done, and the organism was identified as Salmonella Paratyphi B with the help of other biochemicals. The isolate showed susceptibility to chloramphenicol and cotrimoxazole and resistance to other panels of antibiotics. Routine blood and urine analysis of the patient showed normal findings. Wound dressing was done on an alternative day, followed by administration of antibiotics. The patient was advised to follow up after two weeks. The clinical outcome in the above patient was satisfactory with appropriate antibiotics. We present a case of atypical typhoidal Salmonella as a rare cause of wound infection and not a major threat if diagnosed and treated accordingly.