Year: 2025 | Month: April | Volume: 15 | Issue: 4 | Pages: 279-284
DOI: https://doi.org/10.52403/ijhsr.20250440
A Rare Case of Salmonella enterica serovar typhi Causing Extensive Abscesses Involving Multiple Sites and Meningeal Inflammation
Apurwa Bhojraj1, Shashikala Shivaprakash2, Mayur Patel3, Himanshu Choudhury4
1Department of Microbiology, 2Department of Microbiology, 3Department of Critical care Medicine, 4Department of Radiology,
1,2,3,4Sir HN Reliance Foundation Hospital, Mumbai, India
Corresponding Author: Shashikala Shivaprakash
ABSTRACT
Salmonella typhi a known cause of enteric fever, is endemic in Indian subcontinent and primarily cause bacteremia and gastrointestinal symptoms. The organism also has the potential to form extraintestinal abscesses in sites such as the liver, spleen, lymph nodes, bones, and joints, this report highlights an unusual manifestation of infection. Diabetes mellitus, haematological malignancies, HIV, immunocompromised states and other comorbidities may contribute to formation of abscess but the exact mechanism of pathogenesis remains unclear.
This case report describes a rare and noteworthy instance of Salmonella Typhi causing multiple abscesses in an immunocompetent patient who did not present with detectable bacteremia. Few reports have documented focal infections in spleen, liver, and brain. These abscesses, however, were found in patients with known Salmonella Typhi bacteremia.
The patient presented with insidious onset lower back pain, and radiological imaging revealed a localized abscess in the gluteal muscle, pelvic wall and presacral space, a site that is not commonly associated with this pathogen. Culture results of the aspirate confirmed the presence of Salmonella Typhi, and the organism was identified using VITEK MS (Mass Spectrometry) and confirmed by serotyping.
Prompt treatment, based on the antimicrobial susceptibility report, was initiated, demonstrating the importance of timely and accurate microbiological identification for proper management, even in the absence of typical bacteraemia symptoms.
Key words: Enteric fever, Gluteal abscess, Salmonella typhi, VITEK MS