Nontyphoidal Salmonella purulent pericarditis presenting with pericardial tamponade in a patient on infliximab therapy

Publication date: Available online 1 February 2019Source: IDCasesAuthor(s): Kimberly Saddler, Miriams T Castro-Lainez, Rafael Deliz-Aguirre, Julieta Munoz, Jorge Augusto Aguilar Espinal, Miguel Sierra-Hoffman, Harish Chandna, Alan Howel, John Midturi, Richard WinnAbstractInfection with nontyphoidal Salmonella is traditionally characterized by intestinal manifestations. However, extra-intestinal infections are known to occur, with purulent pericarditis associated with cardiac tamponade being rare. This case report is of a 57-year-old male with Crohn’s disease initiated on infliximab therapy two months prior to presentation. He presented with recurrent chest pain and a single occurrence of fever. A Computed Tomography (CT) scan of the chest revealed a pericardial effusion. An echocardiogram confirmed the presence of the fluid with tamponade physiology, requiring immediate surgical decompression. The pericardial fluid culture grew Salmonella enterica, despite the patient having only a single episode of fever, disproportionate to the severity of the infection. Conceivably, the lack of systemic symptoms may be attributed to recent infliximab therapy. Upon conducting a literature review, immunosuppressive factors seem to play a significant role in nontyphoid Salmonella enterica pericardial effusion presenting with cardiac tamponade.

Source: IDCases - February 2, 2019 Category: Infectious Diseases Source Type: research