Group DSalmonellaUrinary Tract Infection in an Immunocompetent Male

Abstract

A 62-year-old male with past medical history of benign prostatic hyperplasia presented to the emergency department with complaints of decreased urinary flow, inability to fully empty his bladder, and gross hematuria. Physical examination was unremarkable. Urinalysis revealed large amount of blood and more than 700 white blood cells suggesting a urinary tract infection. Urine culture grew group D Salmonella greater than 100,000 colony-forming units per mL. He was prescribed 6 weeks of trimethoprim/sulfamethoxazole and had resolution of symptoms. Retrospectively, he reported a 3-day history of watery diarrhea about a week prior to onset of urinary symptoms that was presumed to be the hematogenous source in this case. Urinary tract infection from nontyphoidal Salmonella (NTS) is rare and is usually associated with immunosuppression, chronic diseases, such as diabetes or structural abnormalities of the genitourinary tract. Genitourinary tract abnormalities previously reported in the literature that predispose to nontyphoidal Salmonella urinary tract infection include nephrolithiasis, chronic pyelonephritis, retrovesicular fistula, urethrorectal fistula, hydrocele, and post-TURP. We present an exceedingly uncommon case of 62-year-old male with group D Salmonella urinary tract infection predisposed by his history of benign prostatic hyperplasia.

Pyelonephritis Caused by Salmonella Anatum: An Unusual Case

“…Urinary tract infection (UTI) from nontyphoidal serotypes of Salmonella (NTS) is rare and is usually associated with structural abnormalities of the genitourinary tract, immune suppressive status and chronic diseases [1]. We report here the first case of UTI caused by Salmonella enterica ssp.…”

Association between non-typhoidal Salmonella urinary tract infection and Klebsiella pneumoniae lung empyema

“…While this study did not demonstrate any urological abnormalities, it did demonstrate an enlarged prostate, which previously has also been found to be associated with NTS UTI. 15 As the patient was admitted four months prior for a COPD exacerbation, a nosocomial source of his K. pneumoniae infection was considered. This was felt to be unlikely, as a chest x-rays during that admission did not demonstrate a consolidation or empyema, and the patient was well after treatment of his exacerbation.…”

Infección del tracto urinario por salmonella no typhi en paciente diabética

“…Se reporta una incidencia de 0.01 a 0.07% de todos los casos de ITU, pero recientemente ha habido un aumento notable en la incidencia de infecciones por Salmonella no typhi 4 . Se observa más comúnmente en niños y pacientes mayores de 60 años 5 .…”

“…Hay muchos factores de riesgo de las cuales incluyen contacto directo con el agente etiológico (gastroenteritis por Salmonella) hasta la exposición a exóticos reptiles y pacientes con enfermedades crónicas tales como enfermedad cardiopulmonar o hepática, resección gástrica, úlceras duodenales, enfermedad de células falciformes, diabetes mellitus y hemodiálisis. También en esta lista se incluye, la inmunosupresión es un factor de riesgo en pacientes con trasplante renal, VIH / SIDA, reumatológicos, enfermedades tales como lupus eritematoso sistémico y cánceres de tumores hematológicos o sólidos 9-11 . Las ITU por Salmonella no typhi pueden ser muy difíciles de tratar, sugiriéndose que se inicie con antimicrobianos que tengan la capacidad de eliminar agentes intracelulares, como el ciprofloxacino 5 , que fue el primer tratamiento empírico, que parece haber sido efectivo a pesar de su perfil de resistencia visto en la figura 1, puesto que, en el segundo cultivo, la Salmonella ya no se encontraba presente, siendo reemplazado por una E. coli de tipo BLEE.…”

“…La ITU por Salmonella no typhi es rara y generalmente se asocia con anomalías estructurales del tracto genitourinario, inmunosupresión y enfermedades crónicas, como la diabetes. Los modos de infección incluyen la invasión uretral directa, que es más común en mujeres, o diseminación hematógena por gastroenteritis 5 .…”