Aguado J M, Obeso G, Cabanillas J J, Fernández-Guerrero M, Alés J
Department of Internal Medicine (Division of Infectious Diseases), Universidad Autónoma de Madrid, Spain.
Arch Intern Med. 1990 Jan;150(1):54-6.
Medical records of 11 patients with nontyphoid Salmonella pleuropulmonary disease studied from 1960 to 1986 in a general hospital were reviewed. Eight patients (73%) were 60 years old or older, and the median age was in the seventh decade. There was no seasonal variation in the prevalence. The infection was hospital acquired in 4 patients (36%). All patients had one or more (median, 1.5) major underlying diseases. Seven of them had previous abnormalities of the lung or pleura. Severe immunosuppression was present in 7 cases. Pneumonia occurred in 8 patients, lung abscesses in 2, and empyema in 1. All patients with pneumonia had positive blood cultures. A gastrointestinal source of pulmonary infection was not probable because only 2 patients had positive stool cultures. We suggest that the reticulo-endothelial system could be the source of hematogenous spread of nontyphoid Salmonella. The overall mortality was 63%. Pulmonary infection due to Salmonella should be considered among the pathogens associated with gram-negative bacillary pneumonia in elderly patients who are immunosuppressed and have underlying pulmonary disease. Pathogenesis of this infection remains to be clarified.
回顾了1960年至1986年在一家综合医院研究的11例非伤寒沙门氏菌胸膜肺部疾病患者的病历。8例患者（73%）年龄在60岁及以上，中位年龄在七十多岁。发病率无季节性变化。4例患者（36%）的感染是医院获得性的。所有患者都有一种或多种（中位值，1.5种）主要基础疾病。其中7例既往有肺部或胸膜异常。7例存在严重免疫抑制。8例患者发生肺炎，2例发生肺脓肿，1例发生脓胸。所有肺炎患者血培养均为阳性。由于只有2例患者粪便培养阳性，肺部感染不太可能来源于胃肠道。我们认为网状内皮系统可能是非伤寒沙门氏菌血行播散的来源。总死亡率为63%。对于免疫抑制且有基础肺部疾病的老年患者，在与革兰氏阴性杆菌肺炎相关的病原体中应考虑沙门氏菌引起的肺部感染。这种感染的发病机制仍有待阐明。
