Pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphoma

Introduction. Extraintestinal manifestations of nontyphoidal salmonellosis are usually seen in patients with cellular immunodeficiency. Pleural empyema caused by nontyphoidal Salmonella is very rare clinical presentation of salmonellosis and there are just a few cases described in a literat...

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Main Authors: Kojić Miroslav, Nožić Darko, Tarabar Olivera, Perišić Nenad
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2016-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501600004K.pdf
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author Kojić Miroslav
Nožić Darko
Tarabar Olivera
Perišić Nenad
author_facet Kojić Miroslav
Nožić Darko
Tarabar Olivera
Perišić Nenad
author_sort Kojić Miroslav
collection DOAJ
description Introduction. Extraintestinal manifestations of nontyphoidal salmonellosis are usually seen in patients with cellular immunodeficiency. Pleural empyema caused by nontyphoidal Salmonella is very rare clinical presentation of salmonellosis and there are just a few cases described in a literature. We presented a very rare case of pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin limphoma. Case report. A 60-year-old male with low grade B-cell lymphoma, mucosa associated lymphoid tissue (MALT) type in IV clinical degree, manifested with infiltration of stomach, bronchus, pleura and peritoneum was admitted to the hospital. Initially the patient was presented with non-specific symptoms and signs, suggesting poor general condition. During the hospitalization his pleural fluid became purulent and changes in blood counts were registered with the increase of leukocytes, especially neutrophils. A large number of leukocytes was found by microscopic evaluation of pleural fluid and Salmonella enteritidis was isolated by its culture. There were no pathogenic bacteria in stool culture and hemoculture remained sterile. Toxins A and B of Clostridium difficile were not detected in stool. The patient was treated by ciprofloxacin and cefrtiaxone for 14 days with drainage of the purulent content, what was followed by the resolution and organization of the pleural fluid. After the stabilization of his general condition, chemotherapy with cyclophosphamide, vincristine, prednisone (COP) was introduced, with complete response. Conclusion. Although rare, pleural empyema caused by nontyphoidal Salmonella should be considered in patients with severe immunosuppression, because appropriate antimicrobial therapy with surgical measures are very important for the outcome in these patients.
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spelling doaj-art-d3ec3ff662364bb280b0aeecf31be6992025-08-20T02:19:45ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202016-01-0173328028310.2298/VSP141031004K0042-84501600004KPleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphomaKojić Miroslav0Nožić Darko1Tarabar Olivera2Perišić Nenad3Military Medical Academy, Clinic for Infectious and Tropical Diseases, BelgradeMilitary Medical Academy, Clinic for Infectious and Tropical Diseases, Belgrade + University of Defense, Faculty of Medicine of the Military Medical Academy, BelgradeUniversity of Defense, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Hematology, BelgradeMilitary Medical Academy, Clinic for Gastroenterology and Hepatology, BelgradeIntroduction. Extraintestinal manifestations of nontyphoidal salmonellosis are usually seen in patients with cellular immunodeficiency. Pleural empyema caused by nontyphoidal Salmonella is very rare clinical presentation of salmonellosis and there are just a few cases described in a literature. We presented a very rare case of pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin limphoma. Case report. A 60-year-old male with low grade B-cell lymphoma, mucosa associated lymphoid tissue (MALT) type in IV clinical degree, manifested with infiltration of stomach, bronchus, pleura and peritoneum was admitted to the hospital. Initially the patient was presented with non-specific symptoms and signs, suggesting poor general condition. During the hospitalization his pleural fluid became purulent and changes in blood counts were registered with the increase of leukocytes, especially neutrophils. A large number of leukocytes was found by microscopic evaluation of pleural fluid and Salmonella enteritidis was isolated by its culture. There were no pathogenic bacteria in stool culture and hemoculture remained sterile. Toxins A and B of Clostridium difficile were not detected in stool. The patient was treated by ciprofloxacin and cefrtiaxone for 14 days with drainage of the purulent content, what was followed by the resolution and organization of the pleural fluid. After the stabilization of his general condition, chemotherapy with cyclophosphamide, vincristine, prednisone (COP) was introduced, with complete response. Conclusion. Although rare, pleural empyema caused by nontyphoidal Salmonella should be considered in patients with severe immunosuppression, because appropriate antimicrobial therapy with surgical measures are very important for the outcome in these patients.http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501600004K.pdfempyema, pleuraldiagnosissalmonella enteritidislymphoma, non-Hodgkin
spellingShingle Kojić Miroslav
Nožić Darko
Tarabar Olivera
Perišić Nenad
Pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphoma
Vojnosanitetski Pregled
empyema, pleural
diagnosis
salmonella enteritidis
lymphoma, non-Hodgkin
title Pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphoma
title_full Pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphoma
title_fullStr Pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphoma
title_full_unstemmed Pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphoma
title_short Pleural empyema caused by Salmonella enteritidis in a patient with non-Hodgkin lymphoma
title_sort pleural empyema caused by salmonella enteritidis in a patient with non hodgkin lymphoma
topic empyema, pleural
diagnosis
salmonella enteritidis
lymphoma, non-Hodgkin
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501600004K.pdf
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AT tarabarolivera pleuralempyemacausedbysalmonellaenteritidisinapatientwithnonhodgkinlymphoma
AT perisicnenad pleuralempyemacausedbysalmonellaenteritidisinapatientwithnonhodgkinlymphoma