Choi Kun Moo, Park Cheon Soo, Song Gi-Won, Lee Sung-Gyu
Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Division of Liver Transplantation, Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Hepatobiliary Pancreat Surg. 2014 Feb;18(1):29-32. doi: 10.14701/kjhbps.2014.18.1.29. Epub 2014 Feb 24.
Non-typhoid salmonellosis is an infectious disease caused by Salmonella species other than Salmonella typhi. Although the usual clinical course of non-typhoid salmonellosis is a benign self-limiting gastroenteritis, these bacteria are especially problematic in immunocompromised individuals, including patients with malignancies, human immunodeficiency virus, or diabetes, and those receiving corticosteroids or other immunotherapy agents. In addition to enteric symptoms, Salmonella species give rise to extra-intestinal complications, including self-limiting arthritis, which appears 1 to 3 weeks after the onset of infection and lasts from a few weeks to several months. In some patients, however, this arthritis spears to be chronic in nature. We describe herein a living-donor liver transplant recipient who experienced non-typhoid Salmonella-triggered arthritis in the left hip. The patient recovered uneventfully after 6-month-long antibiotics treatment. Clinicians involved in transplantation should be aware of the possibility that transplant recipients, like other immunocompromised individuals, are at risk of salmonellosis and therefore require careful clinical and microbiological evaluation, with the goals of prevention and early recognition of infection.
非伤寒沙门氏菌病是由伤寒沙门氏菌以外的沙门氏菌属引起的一种传染病。虽然非伤寒沙门氏菌病的通常临床病程是良性自限性胃肠炎,但这些细菌在免疫功能低下的个体中尤其成问题,包括患有恶性肿瘤、人类免疫缺陷病毒或糖尿病的患者,以及接受皮质类固醇或其他免疫治疗药物的患者。除肠道症状外,沙门氏菌属还会引发肠外并发症,包括自限性关节炎,这种关节炎在感染发作后1至3周出现,持续数周至数月。然而,在一些患者中,这种关节炎似乎本质上是慢性的。我们在此描述了一名活体供肝移植受者,他在左髋部出现了非伤寒沙门氏菌引发的关节炎。经过6个月的抗生素治疗,患者顺利康复。参与移植的临床医生应意识到,移植受者与其他免疫功能低下的个体一样,有感染沙门氏菌病的风险,因此需要进行仔细的临床和微生物学评估,以预防和早期识别感染。