Tuberc Respir Dis.  2008 Dec;65(6):537-540.

A Case of Empyema and Mediastinitis by Non-typhi Salmonella

• Yang SY
• Kwak HW
• Song JH
• Jeon EJ
• Choi JC
• Shin JW
• Kim JY
• Park IW
• Choi BW

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.

Keyword

Salmonella enteritidis; Empyema; Mediastinitis

MeSH Terms

Adrenal Cortex Hormones
Adult
Anemia, Sickle Cell
Anti-Bacterial Agents
Cephalosporins
Clarithromycin
Collagen
Cough
Empyema
Humans
Immunocompromised Host
Male
Mediastinitis
Metronidazole
Pneumonia
Salmonella
Salmonella enteritidis
Salmonella Infections
Sensation
Streptococcus
Thorax
Vascular Diseases
Adrenal Cortex Hormones
Anti-Bacterial Agents
Cephalosporins
Clarithromycin
Collagen
Metronidazole

Figure

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  Figure 1 (A) Chest PA (before treatment): loculated right pleural effusion. (B) Chest PA (after treatment): decreased amount of right pleural effusion.

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  Figure 2 (A) Chest CT: complete atelectasis with multiple abscess formation in right middle lobe. Mediastinitis is noted. (B) Chest CT: interval improved complete atelectasis with multiple abscess formation and endobronchial obliteration in right middle lobe. Mediastinitis is improved.

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