A Case of Empyema and Mediastinitis by Non-typhi Salmonella

비장티푸스성 살모넬라 감염으로 발생한 농흉과 종격동염 1예

  • Yang, Suh Yoon (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Kwak, Hee Won (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Song, Ju Han (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Jeon, Eun Ju (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Choi, Jae Cheol (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Shin, Jong Wook (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Kim, Jae Yeol (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Park, In Won (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Choi, Byoung Whui (Divisioin of Allergy, Respiratory and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine)
  • 양서윤 (중앙대학교 의과대학 내과학교실) ;
  • 곽희원 (중앙대학교 의과대학 내과학교실) ;
  • 송주한 (중앙대학교 의과대학 내과학교실) ;
  • 전은주 (중앙대학교 의과대학 내과학교실) ;
  • 최재철 (중앙대학교 의과대학 내과학교실) ;
  • 신종욱 (중앙대학교 의과대학 내과학교실) ;
  • 김재열 (중앙대학교 의과대학 내과학교실) ;
  • 박인원 (중앙대학교 의과대학 내과학교실) ;
  • 최병휘 (중앙대학교 의과대학 내과학교실)
  • Received : 2008.06.26
  • Accepted : 2008.09.25
  • Published : 2008.12.30

Abstract

There are few reports of the pleuropulmonary involvement of a non-typhi Salmonella infection in immunocompromised patients with AIDS, malignancy, collagen vascular diseases, extended use of corticosteroids, sickle cell disease, or diabetes. We report a case of a non-immunocompromised patient who presented with concomitant empyema and mediastinitis due to Salmonella without a comorbid disease. A 26-year-old male patient, with a history of pneumonia 5 years earlier and having lived abroad for several years, presented chronic cough and febrile sensation. Pneumonia, empyema and mediastinitis were noted in a chest CT scan and Salmonella enteritidis and ${\beta}-hemolytic$ streptococcus were identified from a culture of the pleural fluid. Initially, he was treated with cefepime, metronidazole and clarithromycin. He was cured clinically and radiographically after an 8 week treatment with antibiotics. In conclusion, this report suggests that S. enteritidis can cause empyema and mediastinitis, albeit rarely.

NTS의 호흡기계 감염은 매우 드문 질환으로 보통 후천성 면역 결핍증, 악성 종양, 교원성 혈관 질환, 스테로이드의 장기간 사용, 겸상적혈구 빈혈증, 당뇨 환자에서 나타난다. 하지만 저자들은 특별한 면역성 질환을 갖고 있지 않은 26세 남자에서 농흉과 종격동염을 진단 후, 환자의 흉수에서 비장티푸스성 살모넬라균이 동정된 1예를 경험하였기에 문헌 고찰과 함께 보고한다.

Keywords

References

  1. Stuart BM, Pullen RL. Typhoid: clinical analysis of three hundred and sixty cases. Arch Intern Med 1946;78: 629-61. https://doi.org/10.1001/archinte.1946.00220060002001
  2. Glaser JB, Morton-Kute L, Berger SR, Weber J, Siegal FP, Lopez C, et all. Recurrent Salmonella typhimurium bacteremia associated with the acquired immunodeficiency syndrome. Ann Intern Med 1985;102:189-93. https://doi.org/10.7326/0003-4819-102-2-189
  3. Jacobs JL, Gold JW, Murray HW, Roberts RB, Armstrong D. Salmonella infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med 1985;102:186-8. https://doi.org/10.7326/0003-4819-102-2-186
  4. Na DY, Soug IH, Park MJ, Yoon KH, Yoo JH, Kang HM. A case of empyema by Salmonella. Tuberc Respir Dis 1995;42:105-9. https://doi.org/10.4046/trd.1995.42.1.105
  5. Mandell GL, Douglas RG, Bennett JE. Principles and practice of infectious diseases. 6th ed. New York: Churchill Livingstone Inc.; 2005.
  6. Cohen JI, Bartlett JA, Corey GR. Extra-intestinal manifestations of Salmonella infections. Medicine (Baltimore) 1987;66:349-88. https://doi.org/10.1097/00005792-198709000-00003
  7. Rim MS, Park CM, Ko KH, Lim SC, Park KO. Pleural empyema due to Salmonella: a case report. Korean J Intern Med 2000;15:138-41. https://doi.org/10.3904/kjim.2000.15.2.138
  8. Aguado JM, Obeso G, Cabanillas JJ, Fernandez-Guerrero M, Ales J. Pleuropulmonary infections due to nontyphoid strains of Salmonella. Arch Intern Med 1990;150:54-6. https://doi.org/10.1001/archinte.150.1.54
  9. Yang CH, Chen KJ, Tseng HH, Yang CJ, Liu JD. Salmonella pericarditis and empyema: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 1995;56:199-204.
  10. Yu VL, Weber R, Raoult D, editors. Antimicrobial therapy and vaccines. 2nd ed. New York: Apple Tree Productions; 2002. p. 583-603.
  11. Pegues DA, Miller SA. Salmonellosis. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison's principles of internal medicine. 17th ed. New York: McGraw-Hill Medical; 2008. p. 956-61.