European Journal of Biomedical and Pharmaceutical Sciences

A RARE CASE OF SALMONELLA ENDOCARDITIS

*Dr. Hamza Ishfaq and Dr. Adil Khan

ABSTRACT

Salmonella enterica are the rod-shaped gram-negative bacterial species that have a rare predilection towards damaged endothelium leading to serious cardiac complications, including infective endocarditis (IE). Infective endocarditis is a serious complication and, in most cases, proves fatal. Among 16 large case series from 1976 to 2014, they accounted for less than 0.01% and up to 2.9% of bacterial endocarditis cases. We present a unique case of infective endocarditis in a 59-year-old African American male due to Salmonella enterica serovar Typhi infection. With a history of alcohol, tobacco use, marijuana use, and intravenous drug abuse, this patient presented to the emergency department with altered mental status for two days. Vital signs showed hypotension, tachypnea, tachycardia with fever. Exam noticeable for coarse breath sounds bilateral, and heart rate and rhythm were regular. Labs showed Hb 3g/dL, WBCs 20x103 /mm3, platelets 522x109/mm3, creatinine 1.87 mg/dL, serum bicarbonate of 12 mmol/L. On arterial blood gas, PaO2 was 79 mmHg, and PaCO2 was 24 mmHg. Computed tomography of the chest showed multiple septic emboli. Both blood culture and urine cultures came out positive for Salmonella. Initially, the patient was started on intravenous fluids and blood units along with intravenous antibiotics. Transthoracic and transesophageal echocardiography were negative for vegetations but showed moderate tricuspid regurgitation. The patient was diagnosed with Salmonella Typhi endocarditis and treated appropriately. Subsequently, his infection resolved.

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