Hovette P, Camara P, Petrognani R, Donzel C
Service Médicaux, l'Hôpital Principal de Dakar, Sénégal.
Med Trop (Mars). 1998;58(4):403-7.
Salmonella infections are widespread particularly in tropical zones. Each year, 12.5 million cases of typhoid fever are reported with an incidence of 540 cases for every 100,000 inhabitants in developing countries versus 0.2 cases in industrialized countries. Pleuropulmonary manifestations constitute the most common extra-intestinal manifestation of salmonella infection. Counts are usually carried out in the digestive tract. Respiratory tract manifestations result from blood-borne diffusion from mesenteric lymph nodes, but gastroenteritis goes unnoticed in 2 of 3 cases. Predisposing factors are frequent including cancer, previous graft placement and immunosuppressant therapy, sickle cell disease, alcohol abuse, and pre-existing pulmonary disease. Clinical manifestations are usually acute but subacute forms cannot be ruled out. Cough is a common symptom observed in 25% of patients with typhoid fever. Pneumonia is uncommon overall (1%) but occurs in 50% of patients with pleural effusion, empyema, lung abscess, or bronchopleural fistula. A few cases of adult respiratory distress syndrome have been described in the literature. Recognition is important since these manifestations may signal previously unsuspected underlying pulmonary disease. Treatment requires appropriate antimicrobial therapy and close surveillance to prevent recurrence or complications.
沙门氏菌感染广泛存在，尤其是在热带地区。每年报告的伤寒病例有1250万例，发展中国家每10万居民中的发病率为540例，而工业化国家为0.2例。胸膜肺部表现是沙门氏菌感染最常见的肠外表现。通常在消化道进行计数。呼吸道表现是由肠系膜淋巴结血行扩散引起的，但三分之二的肠胃炎病例未被注意到。易感因素常见，包括癌症、既往移植手术、免疫抑制治疗、镰状细胞病、酗酒和原有肺部疾病。临床表现通常为急性，但不能排除亚急性形式。咳嗽是伤寒患者中25%观察到的常见症状。总体而言，肺炎并不常见（1%），但在有胸腔积液、脓胸、肺脓肿或支气管胸膜瘘的患者中，肺炎发生率为50%。文献中描述了几例成人呼吸窘迫综合征病例。认识到这些表现很重要，因为它们可能预示着先前未被怀疑的潜在肺部疾病。治疗需要适当的抗菌治疗和密切监测，以防止复发或并发症。
