Muscle Infections Caused by Salmonella Species: Case Report and Review

Collazos, Julio; Mayo, José; Martínez, Eduardo; Blanco, Maria-Soledad

doi:10.1086/598652

Cited by 43 publications

(24 citation statements)

References 22 publications

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“…In this study, the patient had DM, which is a risk factor for pyomyositis caused by S. enterica serovar Enteritidis. The site of infection in our case was different from that of previous reports, in that the psoas muscle is typically markedly involved in the presence of bacteremia (4,5). Most importantly, patients with Salmonella soft-tissue infections have been reported to have a considerably higher mortality rate, up to one-third of patients, than patients with pyomyositis due to other microorganisms (4).…”

contrasting

confidence: 84%

“…The most common underlying diseases in patients with Salmonella soft-tissue infections are DM, human immunodeficiency virus infection, and malignancy, with S. enterica serovar Enteritidis noted to be the most frequent serotype (4,5). In this study, the patient had DM, which is a risk factor for pyomyositis caused by S. enterica serovar Enteritidis.…”

mentioning

confidence: 68%

“…Muscle and soft-tissue infection due to Salmonella infection is uncommon (4), and the patients in most published cases have been sensitive to extended-spectrum cephalosporins and quinolones. In our case, however, the initial choice of empirical antibiotics was inappropriate compared with previous reports.…”

mentioning

confidence: 99%

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Community-Onset Pyomyositis Caused by a Salmonella enterica Serovar Enteritidis Sequence Type 11 Strain Producing CTX-M-15 Extended-Spectrum β-Lactamase

2015

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cWe report a case of community-onset pyomyositis due to Salmonella enterica serovar Enteritidis in South Korea. The isolated strain was resistant to extended-spectrum cephalosporins and harbored sequence type 11 coproducing CTX-M-15 extendedspectrum ␤-lactamase (ESBL). Physicians should be alert for early diagnosis and appropriate treatment since ESBL-producing nontyphoidal Salmonella infections are difficult to treat without initiation of appropriate empirical antibiotics. CASE REPORTA 73-year-old woman presented to our emergency room from an outside institution with a 2-week history of right inguinal pain and fever. She had been diagnosed with diabetes mellitus (DM) 10 years prior. On admission, her initial vital signs showed a blood pressure range of 130/80 mm of mercury (mm Hg), a heart rate of 88 beats per min, a respiratory rate of 16 breaths per min, and a temperature of 38.3°C. Physical examination revealed swelling, warmth, and tenderness of the right inguinal area. There was no evidence of trauma. Her laboratory results were as follows: white blood cell count, 22 ϫ 10 9 /liter (96% neutrophils); hemoglobin, 9.7 g/dl; platelet count, 548 ϫ 10 9 /liter; alkaline phosphatase, 319 IU/liter; gamma-glutamyl transpeptidase, 115 IU/liter; total bilirubin, 0.74 mg/dl; total protein, 5.4 g/dl; albumin, 2.5 g/dl; blood urea nitrogen, 8 mg/dl; creatinine, 0.73 mg/dl; glycated hemoglobin (HbA1c), 7.4%; lactate dehydrogenase, 725 IU/liter; and C-reactive protein, 207.52 mg/liter. Magnetic resonance imaging (MRI) was performed, and the results revealed osteomyelitis and necrosis of the right pubic bone and pyomyositis of the adductor and pectineus muscles (Fig. 1). On the day of admission, the patient underwent debridement of the infected tissue. During the operation, purulent material around the right rectus abdominis and adductor muscles and a severe osteolytic lesion in the right pubic bone were removed. Intravenous ceftriaxone and metronidazole were administered empirically.A group D nontyphoidal Salmonella isolate was identified in the peripheral blood drawn at the outside institution prior to admission to our hospital. The specimen collected during debridement in our operating room also revealed the presence of the same bacterial species. Regarding the past medical history of the patient, she did not have a history of trauma and had not recently traveled abroad. She had not been treated with antimicrobial agents or hospitalized within the last 3 months. She did not report any symptoms suggestive of food poisoning such as nausea, vomiting, diarrhea, or abdominal pain. She did not have a history of contact with animals and had not eaten eggs, poultry, or meat within 2 weeks of admission.On hospital day 4, her antibiotic regimen was changed to meropenem in accordance with the antimicrobial susceptibility results. Intravenous meropenem (2.0 g every 8 h) was administered to the patient for 10 weeks. During her course of antibiotic therapy, four additional incisions and debridements were conducted, after which she im...

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confidence: 84%

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confidence: 68%

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Community-Onset Pyomyositis Caused by a Salmonella enterica Serovar Enteritidis Sequence Type 11 Strain Producing CTX-M-15 Extended-Spectrum β-Lactamase

2015

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“…Diabetes mellitus and human immunodeficiency virus infection are the most common predisposing conditions for systemic salmonella infections (6). Salmonella is a well-recognized cause of endovascular infection in different anatomic sites, of which mycotic aneurysm of the aorta is considered to be the most frequent (13).…”

Section: Case Reportmentioning

confidence: 99%

A Pilot with Pain in His Leg: Thigh Abscess Caused by Salmonella enterica Serotype Brandenburg

Björkman¹,

Nilsson²,

Riesbeck

2002

J Clin Microbiol

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Salmonella enterica serotype Brandenburg is one of the more uncommon serotypes isolated from patients with gastroenteritis. Few cases of extraintestinal infections with serotype Brandenburg have been documented. The first case of a serotype Brandenburg-dependent thigh abscess originating from an atherosclerotic pseudoaneurysm of the femoral artery is reported. CASE REPORTDuring a medium-distance flight, a 57-year-old male Caucasian pilot suddenly experienced sharp pain in his right thigh followed by fever. The patient had hypercholesterolemia and non-insulin-dependent diabetes mellitus regulated by diet. In addition, he had previously experienced mild claudicatio intermittens in his right leg and had thus been prescribed acetylsalicylic acid. On the following day, he was seen by his general physician, who found no signs of deep venous thrombosis and prescribed diclofenac for symptomatic relief. During the subsequent week, the thigh swelling increased and the fever persisted. Five days after the initial symptoms, a tender nonfluctuating mass measuring 10 by 15 cm was found in the right thigh adjacent to the groin. A fine-needle puncture of the mass yielded blood only. A week later, magnetic resonance tomography of the thigh showed an extensive swelling surrounded by soft-tissue edema ( Fig. 1A and B). A pseudoaneurysm of the right femoral artery with extensive collateral circulation was identified by intravenous angiography (Fig. 1C). Empirical antibiotic therapy with difloxacillin (750 mg three times orally) was initiated. However, the patient's condition deteriorated with expansion of the soft tissue mass and persistent fever. The patient was admitted to the hospital. On admission, the leukocyte count was 16.6 ϫ 10 9 /liter with a predominance of neutrophils, the erythrocyte sedimentation rate and C-reactive protein level were 84 mm/h and 160 mg/liter, respectively, and the hemoglobin level was 124 g/liter. Liver and renal function tests were normal. Therapy with intravenously administered cefuroxime was initiated, after which the fever disappeared; however, the soft tissue mass remained unchanged. Three weeks after onset of symptoms, an abscess in the thigh muscles with close connection to the femur was incised and drained of pus. The patient's condition improved rapidly after the surgical intervention. Culture of pus from the abscess revealed growth of Salmonella species strain O4. Bone scintigraphy showed no pathological uptake in the femur or elsewhere in the skeleton. The patient was treated with oral levofloxacin for 3 months with no signs of recurrent infection. Interestingly, 2 weeks prior to the onset of disease, our patient had been to Tunisia, where he had experienced transient gastrointestinal discomfort without diarrhea or fever.The bacterial organism was isolated from the abscess fluid after 4 days of incubation using aerobic flasks with liquid medium (BacT/Alert; Organon Teknika). The isolate was subcultured onto supplemented human blood agar plates containing Columbia II agar, L-cysteine, hemin,...

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“…Soft tissue infections are rare, accounting for 6%-12% of all Salmonella infections [1,17]. Most of the infections are caused by NTS [17].…”

Section: Discussionmentioning

confidence: 99%

Extra-intestinal salmonellosis in a tertiary care center in South India

Sudhaharan

Padmaja

Solanki

et al. 2014

J Infect Dev Ctries

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Introduction: The present study is a retrospective analysis of a total of 36 cases of bacteriologically proven extra-intestinal salmonellosis, managed at Nizam's Institute of Medical Sciences, between 1987 and 2012 (25 years). The extra-intestinal sites involved were the skin, cerebrum, spleen, ovary, synovium, and the skeletal muscle. Methodology: The extra-intestinal specimens were first processed using standard methods. Colonies suspected as Salmonella were identified by standard laboratory methods, initially by manual biochemical reactions and later by the API system (bioMerieux, Marcy l'Etoile-France) and the Vitek-2 system (bioMerieux). All the Salmonella isolates were sent to Central Research Institute, Kasauli, for serotyping. Results: The predominant serotype isolated was Salmonella Typhi (S. Typhi) in 27 (75%) patients, followed by Salmonella Senftenberg (S. Senftenberg) in 5 (14%), Salmonella Paratyphi A (S. Paratyphi A) in 3 (8%), and Salmonella Typhimurium (S. Typhimurium) in 1 (3%). There was an increasing resistance to ampicillin, chloramphenicol, cephalosporins (third generation), and quinolones over the 25 years.Conclusions: The diagnosis of extra-intestinal salmonellosis requires a high degree of clinical suspicion and should be included in the differential diagnosis in patients with deep-seated abscesses.

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Muscle Infections Caused by Salmonella Species: Case Report and Review

Cited by 43 publications

References 22 publications

Community-Onset Pyomyositis Caused by a Salmonella enterica Serovar Enteritidis Sequence Type 11 Strain Producing CTX-M-15 Extended-Spectrum β-Lactamase

Community-Onset Pyomyositis Caused by a Salmonella enterica Serovar Enteritidis Sequence Type 11 Strain Producing CTX-M-15 Extended-Spectrum β-Lactamase

A Pilot with Pain in His Leg: Thigh Abscess Caused by Salmonella enterica Serotype Brandenburg

Extra-intestinal salmonellosis in a tertiary care center in South India

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