title: Salmonella arizona arthritis and septicemia associated with rattlesnake ingestion by patients with connective tissue diseases. A dangerous complication of folk medicine.
abstract: Snakes constitute the main reservoir of Salmonella arizona, which are opportunistic pathogens in patients with serious underlying diseases. The 2 may meet when such patients ingest uncooked snake flesh, most often as a folk remedy for arthritis or other conditions. We have seen 11 patients in whom Salmonella arizona infection was documented. Six had systemic lupus erythematosus and another had dermatomyositis and are described in detail. All 7 had received prednisone, which was combined with azathioprine in 3. Five developed septic arthritis, including the site of a hip prosthesis in one patient. A history of dessicated rattlesnake ingestion as a "natural" remedy in either capsule or powder form was obtained in all but one of the 7 patients. Patients often think that if natural or folk remedies are not helpful they also are not harmful and, therefore, safe and worth trying. We disprove that belief and call attention to the perils of one such remedy: dessicated rattlesnake, particularly when ingested by patients with connective tissue diseases who may be immunocompromised.
authors.affiliation: Department of Immunology and Rheumatology, Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Kraus
authors.forename: G
authors.initials: G
authors.lastname: Guerra-Bautista
authors.forename: D
authors.initials: D
authors.lastname: Alarcón-Segovia
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001170:Arthritis, Infectious / Q000150:complications* / Q000188:drug therapy; D001379:Azathioprine / Q000627:therapeutic use; D003240:Connective Tissue Diseases / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D012480:Salmonella Infections / Q000150:complications* / Q000188:drug therapy; D012476:Salmonella arizonae / Q000302:isolation & purification*; D018805:Sepsis / Q000150:complications* / Q000188:drug therapy; D012911:Snakes / Q000382:microbiology*; D011795:Surveys and Questionnaires
chemical_list: D001379:Azathioprine; D011241:Prednisone