Ravella Venkatasubramanyam Nandhini, Ramanan Lavanya, Prabhakaran Neelusree, Nandhagopal Manivannan
Department of Microbiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Science, Chennai, IND.
Cureus. 2024 Aug 2;16(8):e66000. doi: 10.7759/cureus.66000. eCollection 2024 Aug.
Atypical infection usually presents with unusual symptoms in addition to gastroenteritis. Such atypical presentations can pose a challenge for diagnosis and treatment as they may be misdiagnosed, leading to delayed care and potential complications. Here we report an unusual case of spp. isolated from a wound swab. A 57-year-old male patient with a history of uncontrolled type 2 diabetes presented to the general surgery department with a 25-day history of swelling, ulceration, and purulent discharge on his right foot. A wound swab was collected for culture and sensitivity. Gram staining showed occasional pus cells and a few gram-negative bacilli. Culture was done, and the organism was identified as Paratyphi B with the help of other biochemicals. The isolate showed susceptibility to chloramphenicol and cotrimoxazole and resistance to other panels of antibiotics. Routine blood and urine analysis of the patient showed normal findings. Wound dressing was done on an alternative day, followed by administration of antibiotics. The patient was advised to follow up after two weeks. The clinical outcome in the above patient was satisfactory with appropriate antibiotics. We present a case of atypical typhoidal as a rare cause of wound infection and not a major threat if diagnosed and treated accordingly.
非典型感染除肠胃炎外通常还伴有异常症状。此类非典型表现可能给诊断和治疗带来挑战,因为它们可能被误诊,导致治疗延误和潜在并发症。在此,我们报告一例从伤口拭子中分离出的罕见病例。一名57岁男性患者,有2型糖尿病控制不佳病史,因右脚肿胀、溃疡和脓性分泌物25天就诊于普通外科。采集伤口拭子进行培养和药敏试验。革兰氏染色显示偶见脓细胞和少量革兰氏阴性杆菌。进行了培养,并借助其他生化指标将该菌鉴定为副伤寒乙杆菌。该分离株对氯霉素和复方新诺明敏感,对其他抗生素耐药。患者的常规血液和尿液分析结果正常。隔天进行伤口换药,随后给予抗生素治疗。建议患者两周后复诊。上述患者经适当抗生素治疗后临床结果令人满意。我们报告一例非典型伤寒作为伤口感染的罕见原因,若能相应诊断和治疗则并非重大威胁。