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健康男性沙门氏菌肠炎致 Fournier 坏疽:罕见的异常感染。

Fournier's Gangrene Due to Salmonella Typhimurium in a Healthy Male: A Rare Aberrant Infection.

机构信息

Department of Microbiology, Government Medical College and Hospital, Chandigarh sector 32, India.

Department of General Surgery, Government Medical College and Hospital, Chandigarh sector 32, India.

出版信息

Infect Disord Drug Targets. 2021;21(6):e170721188115. doi: 10.2174/1871526520666201117143421.

DOI:10.2174/1871526520666201117143421
PMID:33208080
Abstract

INTRODUCTION

Human Salmonella infections have been classically distinguished into diseases caused by typhoidal and non-typhoidal salmonella (NTS). Typhiodal salmonella includes S. enterica serovars Typhi and Paratyphi that cause the systemic disease but are restricted to human infections, while NTS consists mainly of other serovars that predominantly cause self-limiting gastroenteritis in humans. Localisation of foci with persisting infection occurs due to dissemination of the bacteria throughout the body and can cause a variety of rare clinical syndromes at aberrant sites. Fournier's gangrene, a rapidly progressive, often fatal, necrotizing fasciitis of the external genitalia and perineum due to Salmonella typhimurium, is a rare manifestation and has never been reported.

CASE

A 22-year-old male, apparently healthy patient with no relevant past medical history, was presented to surgical emergency with chief complaints of swelling of bilateral scrotal area. Infective etiology was considered and a diagnosis of Fournier's gangrene was made. Pure growth of Salmonella typhimurium was obtained after repeated subculture and was identified biochemically and on serotyping, as Salmonella enterica, Serotype typhimurium using specific antisera.

CONCLUSION

In our case report, we describe a case of Fournier's gangrene due to Salmonella Typhimurium in an otherwise healthy male to highlight the unusual presentation of Non typhoidal salmonellae at an aberrant site. We also emphasize the importance of using selective media like Selenite F broth for isolation of Salmonella typhimurium from a pus sample.

摘要

简介

人类沙门氏菌感染传统上分为伤寒和非伤寒沙门氏菌(NTS)引起的疾病。伤寒沙门氏菌包括导致全身性疾病的 S. enterica 血清型 Typhi 和 Paratyphi,但仅限于人类感染,而 NTS 主要由其他血清型组成,这些血清型主要在人类中引起自限性胃肠炎。由于细菌在全身传播,感染病灶的定位会持续存在,并可能导致各种罕见的异位临床综合征。福尼尔坏疽是一种由鼠伤寒沙门氏菌引起的外生殖器和会阴的快速进展、常致命的坏死性筋膜炎,是一种罕见的表现,从未有过报道。

病例

一名 22 岁男性,无明显既往病史,以双侧阴囊肿胀为主诉就诊于外科急诊。考虑感染性病因,诊断为福尼尔坏疽。经反复亚培养后,获得鼠伤寒沙门氏菌的纯培养物,并通过生化和血清分型鉴定为沙门氏菌属,血清型鼠伤寒沙门氏菌。

结论

在我们的病例报告中,我们描述了一例由鼠伤寒沙门氏菌引起的福尼尔坏疽,发生在一名健康男性,以强调非伤寒沙门氏菌在异常部位的不常见表现。我们还强调了使用选择性培养基(如亚硒酸盐肉汤)从脓液样本中分离鼠伤寒沙门氏菌的重要性。

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