Volume 27, Number 3—March 2021
Dispatch
Extraintestinal Seeding of Salmonella enterica Serotype Typhi, Pakistan
Seema Irfan
, Mohammad Zeeshan, Salima Rattani, Joveria Farooqi, Sadia Shakoor, Rumina Hasan, and Afia Zafar
, Mohammad Zeeshan, Salima Rattani, Joveria Farooqi, Sadia Shakoor, Rumina Hasan, and Afia Zafar
Table 2
Clinical characteristics of 11 patients who had XDR Salmonella enterica serotype Typhi isolated from blood, feces, and urine versus other body sites, Pakistan 2013−2018*
| Patient ID | Age, y | Diagnosis | Manifestation | Concurrent condition/history | Procedure/specimen | Organism/drug susceptibility pattern | Drug used before culture report | Drug used after culture report/duration, wk | Patient status at follow up |
|---|---|---|---|---|---|---|---|---|---|
| 1 |
13 |
Right gluteal abscess |
Right gluteal swelling, high grade fever for 1 mo |
None |
Incision and drainage/pus aspirate |
Salmonella Typhi//XDR strain |
Oral and IM antipyretics, cefepime, clindamycin, ciprofloxacin |
Azithromycin, meropenem/2 |
Improved |
| 2 |
17 |
Right gluteal abscess |
Right gluteal swelling, nonresolving fever 2 wk |
None |
Incision and drainage/pus aspirate |
Salmonella Typhi/XDR strain |
IM antipyretic, amoxicillin/clavulanate |
Azithromycin, meropenem/2 |
Improved |
| 3 |
55 |
Splenic abscess |
Pain in left upper abdomen, fever for 2 wk |
Road traffic accident and suspected splenic injury 3 years ago |
Ultrasound-guided aspiration/pus aspirate |
Salmonella Typhi/XDR strain |
Ceftriaxone, metronidazole, antipyretics |
Meropenem/not known |
Improved |
| 4 |
10 |
Right leg abscess |
Right leg swelling at fracture site, fever for 2 wk |
Right leg fracture |
Incision and drainage/pus aspirate |
Salmonella Typhi/XDR strain |
Azithromycin, antipyretics |
Meropenem, azithromycin/not known |
Improved |
| 5 |
15 |
Acute meningitis |
Altered level of consciousness, seizures, fever for 2 wk |
None |
Lumbar puncture/CSF |
Salmonella Typhi/XDR strain |
Ceftriaxone, antipyretics |
Meropenem/2 |
Improved |
| 6 |
15 |
Splenic abscess |
Pain in left upper quadrant of abdomen, intermittent fever for 1 y |
Recurrent episodes of pallor and jaundice for 2 y, positive result for antinuclear antibody |
Ultrasound-guided drainage/pus aspirate |
Salmonella Typhi/XDR strain |
Meropenem, antipyretics |
Meropenem/3 |
Improved |
| 7 |
55 |
Left pleural effusion |
Pain in left side of chest and shortness of breath |
Smoked for 30 y, high-grade fever for 3 mo, back pain |
Pleural tap, chest tube/pleural fluid |
Salmonella Typhi/XDR strain |
Multiple antimicrobial drugs (unknown), antipyretics |
Meropenem/not known |
Improved |
| 8 |
40 |
Right deltoid abscess |
Fever, vomiting, abdominal pain, right arm swelling for 2 wk |
None |
Ultrasound-guided drainage/pus aspirate |
Salmonella Typhi/XDR strain, MRSA, Salmonella Typhi |
Azithromycin, intramuscular antipyretics |
Meropenem, azithromycin/2 |
Improved |
| 9 |
9 |
Subdiaphragmatic abscess |
Fever, pain in abdomen |
NA |
NA/pus aspirate |
Salmonella Typhi/XDR strain |
NA |
NA |
NA |
| 10 |
16 |
Ileal perforation and pneumoperitoneum |
High-grade fever for 1 mo, abdominal pain and distension |
None |
Laparotomy, ileostomy/abdominal fluid |
Salmonella Typhi/XDR strain, Escherichia coli, Enterococcus spp. |
Multiple empiric antimicrobial drugs (unknown), antipyretics |
Meropenem, azithromycin/2 |
Improved |
| 11 | 45 | Breast abscess | Fever for 10 d, right breast swelling | Diabetes mellitus | Incision and drainage/ pus aspirate | Salmonella Typhi/XDR strain | Antipyretics | Meropenem, azithromycin/2 | Improved |
*ID, identification; IM, intramuscular; MRSA, methicillin-resistant Staphylococcus aureus; NA, not available; XDR, extensively drug resistant..
Page created: December 07, 2020
Page updated: February 21, 2021
Page reviewed: February 21, 2021
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