Ovarian abscess caused by Salmonella enterica serovar Typhi: a case report

Abstract

Background Typhoid fever is a human-specific disease caused by a bacterium, Salmonella enterica subspecies enterica serovar Typhi. It is transmitted through ingestion of contaminated food or water. It is mostly diagnosed by blood culture. Salmonella Typhi usually manifests as a febrile illness with bacteremia after initial entry through the gastrointestinal route, but it can occasionally cause significant disease in extraintestinal sites. We report a case of a girl in Fiji with a right ovarian abscess infected by Salmonella Typhi. Case presentation A 14-year-old iTaukei (indigenous Fijian) girl presented to our hospital with abdominal pain of 1 month’s duration. Two days prior to her admission, she developed high-grade fever and nausea and had one episode of vomiting. On presentation, she appeared unwell; she was tachycardic (116 beats per minute) and febrile (38.8 °C). Her abdominal examination revealed generalized tenderness. Other examination findings were normal. The provisional diagnosis of abdominal sepsis led to an emergency laparotomy during which an enlarged right ovary was found to be spontaneously discharging pus. The ovary was incised and drained, and the patient was commenced on intravenous ceftriaxone 1 g twice daily, cloxacillin 1 g four times daily, and metronidazole 500 mg three times daily. She recovered promptly and was discharged to home on the sixth postoperative day. The purulent material from the ovary grew Salmonella Typhi. Conclusion Extraintestinal infections caused by Salmonella Typhi are rare but can cause severe and life-threatening disease. Our patient had a prolonged history of abdominal pain and was found to have a ruptured right ovarian abscess due to Salmonella Typhi. Ovarian abscesses in girls who are not sexually active are not associated with pelvic inflammatory disease and suggest local or hematogenous spread. This case report may increase health workers awareness to include common and endemic infections in the differential diagnosis of unusual clinical presentations to help the initiation of appropriate investigation and management as quickly as possible.

Non Typhoidal Salmonella Suppuration of Ovarian Cyst with Sclerosing Peritonitis: An old disease, A New Face

“…Focal metastatic Salmonella infections are seen in almost every site in the body, attracted by a pre-existent ovarian lesion, or simply by the immunologically privileged ovary. Reports of infected ovarian abscesses in adolescents without sexual contact, suggest a hematogenous or gastrointestinal mode of spread, as hypothesized by Taylor [5,8,9]. This route of infection is also likely in our patient, where a paraovarian cyst was infected and the adjacent fallopian tubes did not show evidence of inflammation.…”

“…There have been several reports of infection of ovarian cysts by Salmonella [5][6][7][8][9][10][11][12]. Focal metastatic Salmonella infections are seen in almost every site in the body, attracted by a pre-existent ovarian lesion, or simply by the immunologically privileged ovary.…”

Gastrointestinal and Hepatobiliary Complications of Extensively Drug-Resistant Typhoid at a Tertiary Care Hospital in Pakistan

“…Other GI and abdominal complications that have been reported to be associated with typhoid fever include acalculus cholecystitis, Gram negative sepsis leading to gall bladder gangrene and perforation, concomitant gall bladder and ileal perforation, duodenal ulceration with polyserositis, ileal ulceration with hematochezia, abdominal abscess, ovarian abscess, pancreatitis leading to pancreatic abscess, mesenteric lymphadenitis, and ascites. None of these complications were observed in any of our patient with typhoid fever [13,25,[27][28][29][30].…”

Modern approaches to the choice of antimicrobial agents for pelvic inflammatory diseases: the role of innovative microbiological methods

“…Саме ці мікроорганізми, за даними звіту Центрів з контролю і профілактики захворювань (Centers for Disease Control and Prevention, CDC) США від 2019 року, належать до 11 серйозних загроз антибіотикорезистентності (АР) [12]. Окрім цього, в літературі зустрічається все більше повідомлень про випадки важких форм ЗЗОМТ (ТОА, пельвіоперитоніт і сепсис), викликаних атиповими патогенами як в імуноскомпрометованих, так і в імунокомпетентних жінок, і навіть у сексуально неактивних дівчатпідлітків [13][14][15][16][17][18][19][20][21][22].…”

“…Описані випадки рідкісних атипових збудників важких форм ЗЗОМТ (ТОА, пельвіоперитоніт, сепсис), спричинені атиповими збудниками: абсцес яєчника у cексуально неактивної дівчинки-підлітка, викликаний Salmonella enterica serovar Typhi [14];…”