Pyogenic liver abscess caused by Salmonella Enteritidis: A rare case report

Abstract

Salmonella Enteritidis is one of the most important serovars transmitted from animals to humans and a serovar most commonly reported worldwide. Infection with Enteritidis is mainly limited to the intestinal tract, but under certain circumstances may cross the mucosal barrier to disseminate and get established as some localized infectious focus. Although cited as one of the very uncommon causes, Enteritidis may involve the liver and evolve into an overt abscess. Pyogenic liver abscess by a gas forming organism like Enteritidis usually follow a serious fulminant course and associated morbidity and mortality is unacceptably high unless immediate therapeutic interventions are initiated.

Salmonella enterica Serovar Enteritidis Liver Abscess after Blunt Abdominal Trauma

“…S. enterica serovar Enteritidis is rarely described as a liver abscess pathogen ( 2 , 5 ). In contrast to all other Salmonella serovars, S. enterica serovar Enteritidis has the potential to form a gas from carbohydrates.…”

“…In contrast to all other Salmonella serovars, S. enterica serovar Enteritidis has the potential to form a gas from carbohydrates. The gas accumulation results in an impaired transport of nutrients in adjacent tissues and promotes tissue destruction ( 2 ). This makes S. enterica serovar Enteritidis an extremely noxious pathogen.…”

“…These blunt trauma complications include: haematoma rupture, intra-abdominal abscess, bowel obstruction or ileus, biliary leakage and/or biloma and abdominal compartment syndrome. If the abscess develops, the infected organism usually reflects a bowel flora, with the most frequent isolates being aerobic Gram-negative bacilli (such as Escherichia coli and Klebsiella ) and anaerobes ( Bacteroides fragilis ) ( 2 ).…”

Diagnostic difficulty of liver lesion

“…The incidence of fungal liver abscess is rare compared to pyogenic or amebic liver abscess. [ 1 ] Routes of exposure of bacteria can occur by biliary tree, portal vein, hepatic artery, direct extension, and cryptogenic abscess. Fungal and mycobacterial liver abscesses are rare and mostly associated with immunosuppression.…”