Salmonella enterica Serovar Enteritidis Liver Abscess after Blunt Abdominal Trauma

Abstract

_Salmonella enterica serovar Enteritidis is among the most reported serotypes of Salmonella species worldwide, but is rarely reported as the causative agent of a liver abscess. Case Report_ We present a patient with an abdominal blunt trauma. An initial abdominal computed tomography scan revealed a rupture of the right kidney and of the liver. Two days later, his physical state deteriorated and a new computed tomography scan was obtained. An extremely large 8-centimetre liver abscess was verified. Due to the unsatisfying response to antibiotic therapy and percutaneous drainage, we operated on the patient. An appendectomy, cholecystectomy and bisegmental liver resection were performed. An intraoperative swab from the abscess was positive for Salmonella enterica serovar Enteritidis. The patient was given intravenous ciprofloxacine. The post-operative course was complicated by a Coagulase-negative Staphylococcus infection of the wound, which improved with antibiotic therapy. Conclusion_ Blunt abdominal trauma may initiate an unpredictable course of the disease in chronic Salmonella carriers_

Keywords

• Salmonella enteritidis, liver, abscess

References

1. 1. Bège T, Brunet C, Berdah SV. Hollow viscus injury due to blunt trauma: A review. J Visc Surg 2016;153:61-8.
2. 2. Mahajan RK, Sharma S, Madan P, Duggal N. Pyogenic liver abscess caused by Salmonella Enteritidis: A rare case report. Indian J Pathol Microbiol 2014;57:632-4.
3. 3. Gunn JS, Marshall JM, Baker S, Dongol S, Charles RC, Ryan ET. Salmonella chronic carriage: epidemiology, diagnosis and gallbladder persistence. Trends Microbiol 2014;22: 648-55.
4. 4. Hendriksen RS, Vieira AR, Karlsmose S, Lo Fo Wong DM, Jensen AB, Wegener HC. Global monitoring of Salmonella serovar distribution from the World Health Organization Global Foodborne Infections Network Country Data Bank: results of quality assured laboratories from 2001 to 2007. Foodborne Pathog Dis 2011;8:887-900.
5. 5. Cerwenka H, Werkgartner G, Bacher H, el-Shabrawi A, Mischinger HJ. Intrahepatic hematoma with secondary Salmonella infection via biliary fistula. Hepatogastroenterology 1997;44:529-32.
6. 6. The European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0, 2014. [Internet]. [Cited 2017 Jan 24]. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/ Breakpoint_tables/Breakpoint_table_v_4.0.pdf
7. 7. Crum Cianflone NF. Salmonellosis and the GI Tract: More than Just Peanut Butter. Curr Gastroenterol Rep 2008;10:424-31.
8. 8. Ban B, Vodopija R, Žagar Petrović M, Matica B. Epidemiological characteristics of salmonellosis in New Zagreb during the 1990-2009 period. Acta Med Croat 2011;65:41-7.

9. 9. Endt K, Stecher B, Chaffron S, Slack E, Tchitchek N, Benecke A, et al. The microbiota mediates pathogen clearance from the gut lumen after nontyphoidal Salmonella diarrhea. PLoS Pathog 2010;9:e1001097.
10. 10. Kaplan GG, Gregson DB, Laupland KB. Population-Based Study of the Epidemiology of and the Risk Factors for Pyogenic Liver Abscess. Clin Gastroenterol Hepatol 2004;2:1032-8.