Pleuropulmonary infections due to nontyphoid strains of Salmonella.
Medical records of 11 patients with nontyphoid Salmonella pleuropulmonary disease studied from 1960 to 1986 in a general hospital were reviewed. Eight patients (73%) were 60 years old or older, and the median age was in the seventh decade. There was no seasonal variation in the prevalence. The infection was hospital acquired in 4 patients (36%). All patients had one or more (median, 1.5) major underlying diseases. Seven of them had previous abnormalities of the lung or pleura. Severe immunosuppression was present in 7 cases. Pneumonia occurred in 8 patients, lung abscesses in 2, and empyema in 1. All patients with pneumonia had positive blood cultures. A gastrointestinal source of pulmonary infection was not probable because only 2 patients had positive stool cultures. We suggest that the reticulo-endothelial system could be the source of hematogenous spread of nontyphoid Salmonella. The overall mortality was 63%. Pulmonary infection due to Salmonella should be considered among the pathogens associated with gram-negative bacillary pneumonia in elderly patients who are immunosuppressed and have underlying pulmonary disease. Pathogenesis of this infection remains to be clarified.
Department of Internal Medicine (Division of Infectious Diseases), Universidad Autónoma de Madrid, Spain.
J M
JM
Aguado
G
G
Obeso
J J
JJ
Cabanillas
M
M
Fernández-Guerrero
J
J
Alés
D000328:Adult; D000368:Aged; D004653:Empyema / Q000209:etiology*; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology*; D012480:Salmonella Infections / Q000453:epidemiology*; D012477:Salmonella enteritidis / Q000302:isolation & purification; D012486:Salmonella typhimurium / Q000302:isolation & purification; D013030:Spain / Q000453:epidemiology