Salmonella pericarditis and pericardial effusion in a patient with systemic lupus erythematosus on haemodialysis

Sabeel, A; Alrajhi, Abdulrahman A.; Alfurayh, Osman

doi:10.1093/ndt/12.10.2177

Cited by 9 publications

(5 citation statements)

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“…This latter peculiarity was noted both in our study as well as in other series which reported that Salmonella infections in their SLE patients were entirely bacteraemic. 1,2 This notwithstanding, focal suppurations (other than the gastrointestinal tract) reported in the literature and in our series include arthritis, 23 osteomyelitis, 23 ± 25 pneumonia, 12 urinary tract infection, 26 meningitis, mycotic aneurysm, 5,27 pericarditis, 28,29 and abscesses of the skin, 30 spleen, 31 lymph node 32 and even the ovary. 33 On the whole, it was not dif®cult to isolate the infective organism.…”

Section: Discussionsupporting

confidence: 51%

Non-thyphoidal salmonellosis in patients with systemic lupus erythematosus. A study of fifty patients and a review of the literature

Lim

Wh²,

Sf³

et al. 2001

Lupus

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The objective of this study was to characterize the clinical profile of lupus patients with non-typhoidal salmonellosis. A retrospective review of the clinical charts of lupus patients diagnosed with bacteriologically proven non-typhoidal salmonellosis over the last 20 y was undertaken, paying special attention to risk factors, clinical presentation and treatment outcome. Most episodes were bacteraemic without a localizing focus; and some patients were afebrile. They usually occurred in patients prone to opportunistic infections, and at times of increased immunosuppression given for lupus flares (especially nephritis). However, salmonellosis also occurred in some patients presenting with lupus. The C-reactive protein level was found to be significantly higher during the infective episodes compared to episodes of non-infective febrile lupus flare. All isolates were sensitive to the usual first-line antibiotics and eminently treatable with 3 weeks of appropriate antibiotics without recurrence/persistence or significant morbidity/mortality, the exceptions being spinal osteomyelitis and septic arthritis involving deformed joints requiring surgical debridement and prolonged antibiotic therapy for eradication. Mortality occurred in the setting of septic shock from mixed-microbial sepsis and major organ failure from active lupus. There is a high association of non-epidemic, non-typhoidal salmonellosis with SLE, especially in patients with active disease on intensified immunosuppression. The C-reactive protein value may be helpful in distinguishing between fever from a pure lupus flare and one complicated by infection.

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Section: Discussionsupporting

confidence: 51%

Non-thyphoidal salmonellosis in patients with systemic lupus erythematosus. A study of fifty patients and a review of the literature

Lim

Wh²,

Sf³

et al. 2001

Lupus

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“…Pre-existing pericardial effusion due to uraemia, thoracic surgery and other factors and the immuno-status of patients are important predisposing factors for the development of purulent pericarditis. Transient salmonella bacteraemia from the gastrointestinal tract has also been previously noted (Sabeel et al, 1997). Our patient was known to have pericardial effusion symptoms at least 2 weeks before his presentation.…”

Section: Discussionsupporting

confidence: 66%

A purulent pericarditis caused by Salmonella typhimurium

Can

Demirbilek

Erdem

et al. 2004

Journal of Medical Microbiology

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“…2,5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] The most common organism was S. enteritidis (58%; 11 cases) followed by S. typhimurium (26%; 5 cases). The white blood cell count was significantly elevated on initial presentation in 58% of cases (11), and approximately half of patients presented with pericardial tamponade (53%; 10 cases).…”

Section: Pericarditismentioning

confidence: 99%

Nontyphoidal Cardiac Salmonellosis: Two Case Reports and a Review of the Literature

Ortiz

Siegal

Kramer

et al. 2014

Texas Heart Institute Journal

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1 Salmonella enteritidis is the most common serotype, presumably as a consequence of frequent chicken and egg contamination.1,2 Most cases of salmonellosis are limited to gastroenteritis, but bacteremia occurs in 3% to 8% of infections; cardiovascular infections, including pericarditis and endocarditis, develop in 1% to 5% of patients.3,4 The pathogenesis of cardiac salmonellosis is related to the quantity of bacteria ingested, the characteristic ability of Salmonella to adhere to damaged endothelium, the strength of the host's immune response, and the host's previous exposure. The sequelae of Salmonella endocarditis, including valve perforation, valve ring abscess, atrioventricular wall perforation, and cusp rupture, result in an estimated mortality rate of up to 75%. 5,6 Identifying patients at risk of cardiovascular salmonellosis is important for early diagnosis and treatment. Case Reports Patient 1A 73-year-old woman presented after 3 days of progressive nausea, diarrhea, fevers, and weakness. Her medical history was significant for asthma, hypertension, and replacements (4 years earlier) of both mechanical mitral and bioprosthetic aortic valves.The patient's initial temperature was 101 °F, her blood pressure was 59/31 mmHg, and her heart rate was 74 beats/min. An electrocardiogram (ECG) showed sinus rhythm. Her white blood cell count was 8,200 K/µL; blood urea-nitrogen level, 42 mg/dL; creatinine level, 2.04 mg/dL; and initial venous lactate level, 1.3 mmol/L. Urinalysis showed 26 to 100 white cells per high-power field, and a chest radiograph showed bilateral pulmonary infiltrates. She was stabilized, started on intravascular levofloxacin (0.75 mg/kg/d), and admitted to the intensive care unit, where she developed rigors and respiratory distress that necessitated endotracheal intubation and mechanical ventilation. A repeat ECG showed a new pattern of left bundle-branch block. An echocardiogram showed heavy mitral annular calcification, which produced a dense artifact around the sewing ring that suggested endocarditis.On the 2nd day of hospitalization, blood-culture results were positive for gramnegative rods. Transesophageal echocardiography revealed an aortic valve abscess and a 1.1 × 0.5-cm vegetation (with a central cavitation) on her mechanical mitral valve (Fig. 1). The presumed source of the endocarditis was the urinary tract infection,

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Salmonella pericarditis and pericardial effusion in a patient with systemic lupus erythematosus on haemodialysis

Cited by 9 publications

References 0 publications

Non-thyphoidal salmonellosis in patients with systemic lupus erythematosus. A study of fifty patients and a review of the literature

Non-thyphoidal salmonellosis in patients with systemic lupus erythematosus. A study of fifty patients and a review of the literature

A purulent pericarditis caused by Salmonella typhimurium

Nontyphoidal Cardiac Salmonellosis: Two Case Reports and a Review of the Literature

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