Nontyphoidal Salmonella as a Cause of Mediastinal Abscess after Aortic Valve Replacement: A Case Report and Review of Postoperative Salmonella Infections

Abstract

Background Nontyphoidal Salmonella (NTS) is a pathogen that causes several human clinical illnesses, most commonly gastroenteritis. Focal infections are rare and are generally reported in the gastrointestinal and genitourinary systems. Very few studies have reported NTS abscess as a postoperative complication. Case report We describe an elderly patient who developed NTS bacteremia and mediastinal abscess after aortic valve replacement. Conclusions This report describes an extremely rare occurrence of an NTS mediastinal abscess complicating a surgical procedure. The patient may have acquired the pathogen from a snake kept as a family pet and likely developed bacteremia followed by seeding of the surgically damaged tissues.

Salmonella-induced pulmonary and pericardial abscesses in a patient presenting with subacute cough

“…The prevalence of invasive infections caused by NTS is increasing worldwide among immunocompromised patients, particularly in developing countries, however they are quite uncommon in immunocompetent hosts [6] . Intrathoracic infection as an extra-intestinal manifestation is very rare with only few cases reported in the literature so far [7] . The risk factors that can lead to intrathoracic NTS infections can be broadly categorized into systemic and local.…”

Nontyphoidal Salmonella as a Cause of Mediastinal Abscess in a Patient With Extensive Cardiac Surgery

“…Imaging is critical to the diagnosis of infection and visualization of the mediastinum. These abscesses are usually described as low-attenuation masses with peripheral ring enhancement on CT imaging [ 3 , 13 ]. While echocardiogram might be the standard screening modality for endocarditis as a potential source of infection, this case serves to highlight that cross-sectional imaging should be considered if a history of previous cardiac surgery is present.…”

“…Case reports have detailed pre-existing risk factors, such as antecedent tissue disruption, immunocompromised state, atherosclerosis, and food or animal exposure. Postoperative mediastinal infections in the context of congenital heart disease are rarer still, with reports mainly occurring in the pediatric age group [ 3 ]. We present a case of NTS-induced mediastinal abscess in an adult male, status post a series of congenital cardiac repairs in the past.…”