Abstract
We are reporting a case of Salmonella paratyphi A in a young female, who presented with acute abdomen, ruptured ovarian cyst, who was operated in emergency. Pus which was aspirated from the ruptured cyst and the peritoneal cavity isolated Salmonella Paratyphi A. She has an episode of Acute Gastro Enteritis 2 months ago treated conservatively then with IV antibiotics-? Sub optimally treated Enteric Fever. Now the patient presented as said above with an infected and a rupture ovarian cyst.
Extra intestinal manifestations of enteric fever are quite rare, however the possibility of the infection may be suspected in patients presenting acutely post an intestinal infection or a fever as we have seen in our case.
With prompt recognition and multidisciplinary management, the patient recovered with no serious sequela.
References
- John J, Van Aart CJ, Grassly NC. The Burden of Typhoid and Paratyphoid in India: Systematic Review and Meta-analysis. PLoS Negl Trop Dis 2016; 10:e0004616.
- Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010. J Glob Health 2012; 2:010401.
- Mogasale V, Maskery B, Ochiai RL, et al. Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment. Lancet Glob Health 2014; 2:e570.
- GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390:1211.
- Marks F, von Kalckreuth V, Aaby P, et al. Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study. Lancet Glob Health 2017; 5:e310.
- Arndt MB, Mosites EM, Tian M, et al. Estimating the burden of paratyphoid a in Asia and Africa. PLoS Negl Trop Dis 2014; 8:e2925.
- Addiman S, Maimaris W, Thomas HL, et al. Public health management of Salmonella Typhi/Paratyphi case and contact screening: lessons from North London. Public Health 2013; 127:207.
- Imanishi M, Newton AE, Vieira AR, et al. Typhoid fever acquired in the United States, 1999-2010: epidemiology, microbiology, and use of a space-time scan statistic for outbreak detection. Epidemiol Infect 2015; 143:2343.
- Jensenius M, Han PV, Schlagenhauf P, et al. Acute and potentially life-threatening tropical diseases in western travelers--a GeoSentinel multicenter study, 1996-2011. Am J Trop Med Hyg 2013; 88:397.
- Boggild AK, Castelli F, Gautret P, et al. Vaccine preventable diseases in returned international travelers: results from the GeoSentinel Surveillance Network. Vaccine 2010; 28:7389.
- Loharikar A, Newton A, Rowley P, et al. Typhoid fever outbreak associated with frozen mamey pulp imported from Guatemala to the western United States, 2010. Clin Infect Dis 2012; 55:61.
- Vollaard AM, Ali S, van Asten HA, et al. Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia. JAMA 2004; 291:2607.
- Karkey A, Thompson CN, Tran Vu Thieu N, et al. Differential epidemiology of Salmonella Typhi and Paratyphi A in Kathmandu, Nepal: a matched case control investigation in a highly endemic enteric fever setting. PLoS Negl Trop Dis 2013; 7:e2391.
- Connor BA, Schwartz E. Typhoid and paratyphoid fever in travellers. Lancet Infect Dis 2005; 5:623.
- Beaulieu AA, Boggild AK. Enteric fever in two vaccinated travellers to Latin America. CMAJ 2011; 183:1740.
- Pakkanen SH, Kantele JM, Kantele A. Cross-reactive immune response induced by the Vi capsular polysaccharide typhoid vaccine against Salmonella Paratyphi strains. Scand J Immunol 2014; 79:222.
- Wahid R, Zafar SJ, McArthur MA, et al. Live oral Salmonella enterica serovar Typhi vaccines Ty21a and CVD 909 induce opsonophagocytic functional antibodies in humans that cross-react with S. Paratyphi A and S. Paratyphi B. Clin Vaccine Immunol 2014; 21:427.
- Parry CM, Hien TT, Dougan G, et al. Typhoid fever. N Engl J Med 2002; 347:1770.
- Farmer JJ II, McWhorter AC, Brenner DJ, et al. The Salmonella-Arizona group of Enterobacteriaceae: Nomenclature classification and reporting. Clin MicrobiolNewsl 1984; 6:63.
- STUART BM, PULLEN RL. Typhoid; clinical analysis of 360 cases. Arch Intern Med (Chic) 1946; 78:629.
- Ostergaard L, Huniche B, Andersen PL. Relative bradycardia in infectious diseases. J Infect 1996; 33:185.
- Hoffman SL, Punjabi NH, Kumala S, et al. Reduction of mortality in chloramphenicol-treated severe typhoid fever by high-dose dexamethasone. N Engl J Med 1984; 310:82.
- Chiu CH, Lin TY, Ou JT. Predictors for extra intestinal infection of non typhoidal Salmonella in patients without AIDS. Int J Clin Pract. 1999; 53: 161-164.
- Ryan KJ, Ray CG. Sherris Medical Microbiology: An Introduction to Infectious Disease. 4th edn. New York: McGraw-Hill. 2004.
- De Jong H, Parry C, van der Poll T, Wiersinga W. Host-pathogen interaction in invasive Salmonellosis. PLoS Pathogens 2012;8:e1002933.
- House D, Bishop A, Parry C, Dougan G, Wain J. Typhoid fever: pathogenesis and disease. Current Opinion in Infectious Diseases 2001;14:573–78.
- Kaur J, Kaistha N, Gupta V, Goyal P, Chander J. Bilateral tuboovarian abscess due to Salmonella paratyphi A: a case report and review of literature. Infectious Disease in Clinical Practice 2008;16:408-10.
- Crump JA, Mintz ED. Global trends in typhoid and paratyphoid fever. Clinical Infectious Diseases 2010;50:241-6.
- Adelman MW, Johnson JH, Hohmann EL, Gandhi RT. Ovarian Endometrioma Superinfected With Salmonella: Case Report and Review of the Literature. Open Forum Infect Dis. 2017; 4: 48.
- Saltzman DH, Evans MI, Robichaux AG, Grossman JH, Friedman AJ. Nongonococcal pelvic abscess caused by Salmonella enteritidis. Obstet Gynecol. 1984; 64: 585-586.
- Ranta T, Kostiala AA. Ciprofloxacin management of pelvic inflammation caused by Salmonella panama. Duodecim. 1989; 105: 58-60.
- Kostiala AA, Ranta T. Pelvic inflammatory disease caused by Salmonella panama and its treatment with ciprofloxacin. Case report. Br J ObstetGynaecol. 1989; 96: 120-122.
- Hung TH, Jeng CJ, Su SC, Wang KG. Pelvic abscess caused by Salmonella: a case report. Zhonghua Yi Xue Za Zhi (Taipei). 1996; 57: 457-459.
- Tohya T, Yoshimura T, Onoda C. Unilateral ovarian abscess caused by Salmonella. Infect Dis Obstet Gynecol. 2003; 11: 217-219.
- Miller AS, Hunstad DA. Salmonella ovarian abscess in an adolescent. Pediatr Infect Dis J. 2007;26: 548-549.
- Tachdjian R, Tourangeau L, Schneider JL, Nel A. Urticaria associated with necrotic uterine leiomyomas infected with salmonella. Obstet Gynecol. 2010; 116: 491-493.
- Gorisek NM, Oresković S, But I. Salmonella ovarian abscess in young girl presented as acute abdomen--case report. Coll Antropol. 2011; 35: 223-225.
Corresponding Author
Dr G Suresh Reddy
Kasturba Medical College, Mangalore, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.11
