Chao Chia-Ter
Renal Division, Department of Internal Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei, Taiwan, ROC.
Med Princ Pract. 2014;23(5):482-4. doi: 10.1159/000358199. Epub 2014 Jan 31.
To present a case of Salmonella bacteremia with a rare metastatic focus.
A 61-year-old male presented with a suicide attempt after ingestion of half a bottle of toilet cleaner. He had a medical history of intravenous drug abuse and major depression. Persistent Salmonella enteritidis bacteremia occurred during his hospitalization, and a search for the primary source of infection disclosed a mycotic abdominal aortic aneurysm. A suppurative lesion was also noted over the left pleural space, and Salmonella empyema was confirmed after thoracentesis. He underwent video-assisted thoracoscopic surgery and endovascular repair of the abdominal aortic aneurysm and was placed on long-term antibiotics, without recurrence.
S. enteritidis involvement of the cardiovascular system is a rare coincidence and results in significant morbidity and mortality. In addition, the phenomenon of secondary metastatic infective foci involving the pleural space has an even lower frequency than that of cardiovascular involvement. Therefore, a high index of suspicion and prompt treatment from the treating physicians are strongly recommended.
报告一例沙门菌血症合并罕见转移病灶的病例。
一名61岁男性在摄入半瓶清洁剂后试图自杀。他有静脉药物滥用和重度抑郁症病史。住院期间发生持续性肠炎沙门菌菌血症，对感染的主要来源进行检查发现一个真菌性腹主动脉瘤。左侧胸腔也发现一个化脓性病灶，胸腔穿刺后确诊为沙门菌脓胸。他接受了电视辅助胸腔镜手术和腹主动脉瘤腔内修复术，并接受长期抗生素治疗，未再复发。
肠炎沙门菌累及心血管系统是一种罕见的巧合，会导致显著的发病率和死亡率。此外，继发转移感染灶累及胸腔的现象比心血管受累的频率更低。因此，强烈建议治疗医生保持高度怀疑并及时治疗。
