Extra-intestinal salmonellosis in a tertiary care centre in South India

Vithiya Ganesan; Shyamala Ravikoti; Raja Sundaramurthy; Monica Raghavan; Rajendran Tiruvanamalai

doi:10.18502/ijm.v16i1.14885

Vithiya Ganesan Department of Microbiology, Velammal Medical College Hospital and Research Institute (VMCH&RI), Madurai, Tamilnadu, India
Shyamala Ravikoti Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bibinagar, Hyderabad, Telangana, India
Raja Sundaramurthy Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bibinagar, Hyderabad, Telangana, India
Monica Raghavan SRM Medical College Hospital and Research Centre, Chengalpattu,Tamilnadu, India
Rajendran Tiruvanamalai Department of Microbiology, Velammal Medical College Hospital and Research Institute (VMCH&RI), Madurai, Tamilnadu, India

DOI: https://doi.org/10.18502/ijm.v16i1.14885

Keywords: Salmonellosis; Salmonella enteritidis; Abscess; Pancreatitis

Abstract

Background and Objectives: Extra-intestinal salmonellosis is associated with higher case fatality and is underestimated in the developing countries like India. Here we present a case series of bacteriologically proven extra-intestinal salmonellosis managed at our institute over the past two years.

Materials and Methods: Retrospective analysis of bacteriologically proven extra-intestinal salmonellosis over two years between January 2020 to December 2021 was carried out. Medical records were reviewed for site of infection, evidence of any underlying or predisposing illnesses and antimicrobial susceptibility report.

Results: Eight patients were diagnosed with extra-intestinal salmonellosis. Male to female ratio was 3:1. Mean age was 44 years. Four were typhoidal and four were nontyphoidal Salmonellae. The extra-intestinal sites involved were purulent aspi- rates from scrotum, caecum, perianal region, intraperitoneal collection, synovium, and urine. Predisposing factors include chronic myeloid leukemia, HIV and gastric malignancy. All deep seated abscess required surgical intervention. All typhoidal Salmonella (n=4) were sensitive to cotrimoxazole, ampicillin, ceftriaxone. Among nontyphoidal Salmonella, one was resis- tant to cotrimoxazole; two were resistant to ampicillin, ceftriaxone and three resistant to ciprofloxacin.

Conclusion: The diagnosis of extra-intestinal salmonellosis requires a high degree of clinical suspicion and should be in- cluded in the differential diagnosis in patients with deep-seated abscesses.