10 SEPTICEMIA DUE TO SALMONELLA BERTI (SEROGROUP D): A RARE CAUSE OF SEPTICEMIA, MULTIORGAN FAILURE, AND DEATH IN AN IMMUNOCOMPETENT PATIENT. (1st January 2006)

• Record Type: Journal Article
• Authors: Dembla, V.; Bean, B.; Ajelabi, A.
• Is Part Of: Journal of investigative medicine. Volume 54:Number 1(2006)
• Page Start: S257
• Page End: S257
• Publication Date: 2006-01-01
• Subjects: Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.2310/6650.2005.X0008.9
• Languages: English
• ISSNs: 1081-5589

Abstract

Abstract : Clinically important Salmonellae, of which 2000 serotypes exist, are now formally classified as a single species, Salmonella choleraesuis ; thus, S. typhi is now S. choleraesusis serotype typhi. We present here a rare case of septicemia/death caused by S. berti, group D serotype of Salmonella . A 58-year-old white male with a history of type II diabetes mellitus and hypertension presented with a witnessed seizure and temperature of 1058F. He was in hemorrhagic/septic shock due to a gastrointestinal (GI) bleed and sepsis with multiorgan dysfunction. The patient's troponin rose to approximately 70 ng/mL. Full anticoagulation could not be initiated due to the ongoing GI bleed. The patient was a chicken farmer by occupation and handled raw chicken 4-5 days before presentation. He was HIV negative. Treatment was initiated empirically with broad-spectrum antibiotics, and the patient stabilized. A nontyphoidal strain, Salmonella berti (group D), sensitive to the antibiotics in use, was isolated on blood cultures by the Mississippi State Department of Health (MSDH). Unfortunately, the patient's condition worsened and he again developed multiorgan failure. Despite our best efforts, the patient expired. Frank sepsis secondary to nontyphoidal strains is rare, and occurrences found in the literature appear to be related to typhoidal strains. Since the year 2000, when MSDH began collecting cases of Salmonella bacteremia, there have been only four recorded cases due to S. berti and none of these have involved multiorgan failure or death. In addition, these remote cases deal with Salmonella sepsis in immunocompromised individuals. We could find no recorded cases in the literature of immunocompetent individuals with sepsis and multiorgan failure due to nontyphoidal strains of Salmonella, and it appears that in the state of Mississippi, our case is the first recorded of its kind causing death from a nontyphoidal strain of Salmonella .