BACKGROUND Acute appendicitis is one of the most common acute abdominal emergencies around the world,which is always associated with infection.Infection with Salmonella typhi,an enteric pathogen,is a rare cause of acu...BACKGROUND Acute appendicitis is one of the most common acute abdominal emergencies around the world,which is always associated with infection.Infection with Salmonella typhi,an enteric pathogen,is a rare cause of acute appendicitis.We here report a patient with acute appendicitis associated with Samonella typhi infection,accompanied with spleen and kidney infarction,providing a rare example for a common surgical emergency.CASE SUMMARY A 25-year-old Pakistani man presented to the hospital with a 3-d history of fevers,vomiting,and abdominal pain.Computed tomography(CT)revealed a thickened intestinal wall of the ileocecal junction with multiple enlarged lymph nodes nearby.He was diagnosed with acute appendicitis and received laparoscopic appendectomy,which showed mild inflammation of the appendix.After the surgery,the patient presented again with a high fever(>39℃)and diarrhea.A CT angiography scan indicated spleen and kidney infarction.According to the blood culture,the diagnosis was finally clear to be Samonella typhi infection.The pyrexia and enteric symptoms were relieved after the application of intravenous levofloxacin.CONCLUSION This case,characterized by the combination of Salmonella typhi infection,acute appendicitis,and renal and splenic infraction,serves as a rare example for a common surgical emergency.展开更多
Non-typhoidal salmonellosis has emerged as an invasive infection in industrialized countries. Bacteremia and pleuropulmonary involvement usually occur in the setting of chronic illnesses such as diabetes, malignancies...Non-typhoidal salmonellosis has emerged as an invasive infection in industrialized countries. Bacteremia and pleuropulmonary involvement usually occur in the setting of chronic illnesses such as diabetes, malignancies and HIV. We present three cases of non-typhoidal salmonellosis in immunocompetent patients presenting over a year period. A 66-year-old female presented with septic shock. She was started on vancomycin, doripenem and ciprofloxacin. Her blood cultures grew Salmonella enteridis that was also isolated from her urine and bronchoalveolar lavage fluid. Stool cultures were negative for Salmonella species. She had no epidemiologic risk factors for invasive Salmonella infection. Her immunodeficiency workup was negative. CT scan abdomen was unremarkable. She became hemodynamically stable and completed a two week course of Ceftriaxone without complications. A 58-year-old female presented with sub-acute onset of fever and dyspnea. CT chest showed bilateral pleural effusions. Left sided thoracentesis revealed purulent fluid consistent with empyema. Pleural fluid cultures grew Salmonella Group D. Blood, sputum and stool cultures remained negative. She denied consumption of raw eggs or exposure to pets, farm animals or reptiles. She was treated with Ceftriaxone for two weeks along with pigtail catheter drainage. Her immunodeficiency workup was negative. A 62-year-old man presented with acute left lower quadrant abdominal pain. CT Abdomen revealed a focal abnormality in abdominal aorta consistent with mycotic aneurysm. Blood cultures grew Salmonella Group D resistant to cephalosporins and bactrim, hence treatment with Meropenem was started. Subsequent blood, respiratory tract, urine and stool cultures remained negative. Due to high risk of perioperative complications, it was decided to follow the mycotic aneurysm expectantly. Antibiotics were deescalated to six weeks of Ertapenem followed by long term quinolone prophylaxis. He also did not have any epidemiologic risk factors for salmonellosis and his immunodeficiency workup was negative. These cases highlight the pathogenesis of this invasive organism that is transmitted though food borne route and causes bacteremic seeding of various sites such as lungs and pleura. It is extremely important to consider this organism in patients presenting with gram negative bacteremia leading to septic shock as well as endovascular infections.展开更多
目的:对一起沙门菌引起的食源性疾病爆发进行溯源分析。方法:采用GB4789法对采集的样品进行分离及鉴定,采用16S r RNA基因分型方法及PFGE分型方法对分离的菌株进行分子生物学分析,并对爆发进行溯源分析。结果:生化及血清学结果表明,该...目的:对一起沙门菌引起的食源性疾病爆发进行溯源分析。方法:采用GB4789法对采集的样品进行分离及鉴定,采用16S r RNA基因分型方法及PFGE分型方法对分离的菌株进行分子生物学分析,并对爆发进行溯源分析。结果:生化及血清学结果表明,该起爆发分离的菌型为伦敦沙门氏菌。16S r RNA基因分型表明爆发所分离的菌株均为肠道沙门菌肠道亚种,菌株12 sam与其他4个菌株分子发育距离较远,均为16S r RNA基因分型的TYPE1-11型;PFGE分型结果表明菌株10 sam、16 sam、27 sam及29sam的PFGE带型相似度为100%,菌株12sam跟其他菌株相似率为96%。结论:GB4789法结果表明该起爆发是由伦敦沙门氏菌引起的,16S r RNA基因分型及PFGE分型方法的结果均表明该起食源性疾病来源一致。展开更多
基金National Natural Science Foundation of China,No.81702586.
文摘BACKGROUND Acute appendicitis is one of the most common acute abdominal emergencies around the world,which is always associated with infection.Infection with Salmonella typhi,an enteric pathogen,is a rare cause of acute appendicitis.We here report a patient with acute appendicitis associated with Samonella typhi infection,accompanied with spleen and kidney infarction,providing a rare example for a common surgical emergency.CASE SUMMARY A 25-year-old Pakistani man presented to the hospital with a 3-d history of fevers,vomiting,and abdominal pain.Computed tomography(CT)revealed a thickened intestinal wall of the ileocecal junction with multiple enlarged lymph nodes nearby.He was diagnosed with acute appendicitis and received laparoscopic appendectomy,which showed mild inflammation of the appendix.After the surgery,the patient presented again with a high fever(>39℃)and diarrhea.A CT angiography scan indicated spleen and kidney infarction.According to the blood culture,the diagnosis was finally clear to be Samonella typhi infection.The pyrexia and enteric symptoms were relieved after the application of intravenous levofloxacin.CONCLUSION This case,characterized by the combination of Salmonella typhi infection,acute appendicitis,and renal and splenic infraction,serves as a rare example for a common surgical emergency.
文摘Non-typhoidal salmonellosis has emerged as an invasive infection in industrialized countries. Bacteremia and pleuropulmonary involvement usually occur in the setting of chronic illnesses such as diabetes, malignancies and HIV. We present three cases of non-typhoidal salmonellosis in immunocompetent patients presenting over a year period. A 66-year-old female presented with septic shock. She was started on vancomycin, doripenem and ciprofloxacin. Her blood cultures grew Salmonella enteridis that was also isolated from her urine and bronchoalveolar lavage fluid. Stool cultures were negative for Salmonella species. She had no epidemiologic risk factors for invasive Salmonella infection. Her immunodeficiency workup was negative. CT scan abdomen was unremarkable. She became hemodynamically stable and completed a two week course of Ceftriaxone without complications. A 58-year-old female presented with sub-acute onset of fever and dyspnea. CT chest showed bilateral pleural effusions. Left sided thoracentesis revealed purulent fluid consistent with empyema. Pleural fluid cultures grew Salmonella Group D. Blood, sputum and stool cultures remained negative. She denied consumption of raw eggs or exposure to pets, farm animals or reptiles. She was treated with Ceftriaxone for two weeks along with pigtail catheter drainage. Her immunodeficiency workup was negative. A 62-year-old man presented with acute left lower quadrant abdominal pain. CT Abdomen revealed a focal abnormality in abdominal aorta consistent with mycotic aneurysm. Blood cultures grew Salmonella Group D resistant to cephalosporins and bactrim, hence treatment with Meropenem was started. Subsequent blood, respiratory tract, urine and stool cultures remained negative. Due to high risk of perioperative complications, it was decided to follow the mycotic aneurysm expectantly. Antibiotics were deescalated to six weeks of Ertapenem followed by long term quinolone prophylaxis. He also did not have any epidemiologic risk factors for salmonellosis and his immunodeficiency workup was negative. These cases highlight the pathogenesis of this invasive organism that is transmitted though food borne route and causes bacteremic seeding of various sites such as lungs and pleura. It is extremely important to consider this organism in patients presenting with gram negative bacteremia leading to septic shock as well as endovascular infections.
文摘目的:对一起沙门菌引起的食源性疾病爆发进行溯源分析。方法:采用GB4789法对采集的样品进行分离及鉴定,采用16S r RNA基因分型方法及PFGE分型方法对分离的菌株进行分子生物学分析,并对爆发进行溯源分析。结果:生化及血清学结果表明,该起爆发分离的菌型为伦敦沙门氏菌。16S r RNA基因分型表明爆发所分离的菌株均为肠道沙门菌肠道亚种,菌株12 sam与其他4个菌株分子发育距离较远,均为16S r RNA基因分型的TYPE1-11型;PFGE分型结果表明菌株10 sam、16 sam、27 sam及29sam的PFGE带型相似度为100%,菌株12sam跟其他菌株相似率为96%。结论:GB4789法结果表明该起爆发是由伦敦沙门氏菌引起的,16S r RNA基因分型及PFGE分型方法的结果均表明该起食源性疾病来源一致。
