[Salmonella enteritidis septicemia manifesting as a suppurated thrombophlebitis].
BACKGROUND
Non-typloid salmonella can cause septicemia and extradigestive disorders in immunodepressed adults. These frequent diseases can be life-threatening.


METHODS
A 76-year-old woman was treated with corticosteroid therapy for 1 year for suppurated thrombophlebitis of the right greater saphenous vein. Weight loss, fever at 41 degrees C and Salmonella enterididis isolated from blood cultures and skin samples led to the diagnosis of septicemia with multiple septic foyers including the venous endothelium and surrounding soft tissue.


CONCLUSIONS
In Western countries, there has been an uprise in the frequency of low-grade salmonella infections by food poisoning usually causing acute diarrhea. S. enterididis can also cause severe infectious syndromes with multiple septic localizations, main in patients with a compromised immune reaction. In our cases, Salmonella enteritidis septecemia was revealed by an unusual situation. In the literature, inaugural signs usually involve the heart or arteries, but our patient had isolated foyers involving the superficial venous network. This is exceptional especially since there was no iatrogenic venous catheter insult. For our patient, favoring factors were the long-term corticosteroid therapy and altered venous network. The portal of entry could not be clearly identified but the discovery of a sigmoid diverticulosis would be an argument favoring a digestive origin. Medical and surgical management with resection of the necrosed tissues and two adapted antibiotics in a long-term regimen led to a successful outcome.
Leccia
M T
MT
Service de Dermatologie, CHU A. Michallon, Grenoble.
Aubry-Artignan
S
S
Brion
J P
JP
Voirin
L
L
Beani
J C
JC
Amblard
P
P
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D016470:Bacteremia / Q000150:complications*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D009336:Necrosis; D011239:Prednisolone / Q000009:adverse effects; D012307:Risk Factors; D012480:Salmonella Infections / Q000150:complications*; D012477:Salmonella enteritidis; D012501:Saphenous Vein; D013492:Suppuration; D013927:Thrombosis / Q000276:immunology / Q000382:microbiology* / Q000473:pathology / Q000628:therapy
D000893:Anti-Inflammatory Agents; D011239:Prednisolone