Nontyphoidal Salmonella purulent pericarditis presenting with pericardial tamponade in a patient on infliximab therapy. (2019)

• Record Type: Journal Article
• Authors: Saddler, Kimberly; Castro-Lainez, Miriams T; Deliz-Aguirre, Rafael; Muñoz, Julieta; Aguilar Espinal, Jorge Augusto; Sierra-Hoffman, Miguel; Chandna, Harish; Howel, Alan; Midturi, John; Winn, Richard
• Is Part Of: IDCases. Volume 15(2018)
• Publication Date: 2019
• Subjects: Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2019.e00500
• Languages: English
• ISSNs: 2214-2509

Abstract

Abstract: Infection 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.