title: Salmonella enterica serovar Minnesota urosepsis in a patient with Crohn's disease in the absence of recent or current gastrointestinal symptoms.
abstract: Salmonella enterica serovar Minnesota is a rarely isolated organism in clinical samples mainly grown from stool cultures. Sepsis due to Salmonella is known in severely immunocompromised patients, but so far urosepsis due to S. enterica serovar Minnesota has not been described. We report a case of a 31-year-old patient suffering from Crohn's disease treated with infliximab and azathioprine, in whom was implanted a double-J ureteric catheter for urolithiasis. The patient presented with urinary tract infection and severe sepsis. S. enterica serovar Minnesota was grown from urine and blood cultures. After empiric antimicrobial treatment with meropenem and vancomycin, treatment was changed to ceftriaxone. Antimicrobial treatment was continued for a total of 3 weeks without evidence of Salmonella recurrence on follow-up visits. Salmonella spp. rarely cause urinary tract infection and sepsis. However, in immunocompromised patients, non-typhoidal salmonellosis merits a thorough clinical and microbiological evaluation.
authors.affiliation: Department of Gastroenterology, Intoxications and Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
authors.forename: Niels
authors.initials: N
authors.lastname: Steinebrunner
authors.affiliation: Department of Gastroenterology, Intoxications and Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
authors.forename: Catharina
authors.initials: C
authors.lastname: Sandig
authors.affiliation: Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zimmermann
authors.affiliation: Department of Gastroenterology, Intoxications and Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.affiliation: Department of Gastroenterology, Intoxications and Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Eisenbach
authors.affiliation: Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Mischnik
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D000069285:Infliximab; D008297:Male; D000077731:Meropenem; D012008:Recurrence; D012480:Salmonella Infections / Q000097:blood / Q000188:drug therapy / Q000652:urine*; D019779:Salmonella enterica / Q000145:classification / Q000302:isolation & purification*; D018805:Sepsis / Q000382:microbiology; D013845:Thienamycins / Q000627:therapeutic use; D062885:Urinary Catheters; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology*; D052878:Urolithiasis / Q000473:pathology; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D013845:Thienamycins; D014640:Vancomycin; D002443:Ceftriaxone; D000069285:Infliximab; D000077731:Meropenem