title: Salmonella bacteremia in systemic lupus erythematosus. Eight-year experience at a municipal hospital.
abstract: Non-endemic Salmonella bacteremia tends to occur in patients with chronic disease. We reviewed all cases of Salmonella infection documented in adults at Bellevue Hospital during the years 1975-1982. Unexpectedly, the most frequent underlying disease found among bacteremic patients was systemic lupus erythematosus (SLE). Patients with SLE accounted for 6 of 30 Salmonella bacteremias as compared with 13 of 2,388 non-Salmonella gram-negative bacteremias. Salmonella was the single most frequent gram-negative isolate from the blood of SLE patients. All lupus patients with Salmonella infection were bacteremic. In contrast, isolates from blood represented only 23% of all Salmonella infections documented in the non-lupus population. Presentation was characterized by fever (greater than 103 degrees F) and abdominal pain. Four of the 6 patients were hypocomplementemic. All were receiving immunosuppressive therapy. We conclude that SLE patients in a municipal hospital setting are at increased risk for Salmonella sepsis. This should be considered when empiric antibiotic therapy is initiated.
mesh_terms: D000293:Adolescent; D000328:Adult; D003428:Cross Infection / Q000209:etiology; D004198:Disease Susceptibility; D004927:Escherichia coli Infections / Q000209:etiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000503:physiopathology; D010044:Outpatient Clinics, Hospital; D012480:Salmonella Infections / Q000209:etiology* / Q000503:physiopathology; D012477:Salmonella enteritidis; D012485:Salmonella typhi; D018805:Sepsis / Q000209:etiology* / Q000503:physiopathology