| brain |
“typhoid encephalopathy”
under severe conditions, Parkinson’s syndrome, motor-neuron
disease, transient amnesia, symmetrical sensory-motor neurotrophy,
schizophreniform psychosis, and Guillain-Barre syndrome |
altered consciousness, delirium,
and confusion along with other rare neurological symptoms like myelitis,
altered sleep pattern, meningitis, and acute psychosis |
|
neuroimaging with magnetic
resonance imaging (MRI), angiography, computed tomography (CT), and/or
radionuclide scans might be handy for diagnosis of brain abscesses,
epidural empyemas, and subdural empyemas |
|
(316−317,318,319) |
| cardiac impairments |
major complications like
(i) myocarditis and (ii) endocarditis to pericarditis and arteritis
as rare complications |
(i) ,icrocirculatory disturbances,
edema, inflammation of the heart intramural vessels, lymphocytic,
and macrophage infiltration of the stroma, sometimes with the formation
of granulomas, and dystrophic and necrotic changes |
underlying cardiac complexities
like heart valvular abnormalities, congenital heart disease, or rheumatic
heart disease |
(i)
abnormal doppler signal,
ECG, CMR, indicators of cardiac injury (CK, AST, and LDH), electromyocardial
biopsy (EMB). (ii) culturing the pathogen from the blood. transthoracic
or transesophageal echocardiography might reveal the presence of vegetation |
antibiotics and supportive
management. |
(320, 321) |
| lung disease |
bronchopneumonia, lobar
pneumonia, pleurisy with effusion, and empyema |
fever, chills, coughs (with
or without sputum), pleuritic pain, coarse crackles and bronchial
breathing on auscultation, diarrhea, and leukopenia |
prior abnormalities of lung
or pleura with the presence of lung malignancies in some cases. mortality
is usually high in geriatric patients, with underlying malignancies
and immunosuppression due to antineoplastic treatments |
chest radiographs or by
isolation of the bacterium from sputum, protected specimen brush (PSB)
material of bronchial secretions |
Salmonella pneumonia calls for
at least 2 weeks of antimicrobial therapy. under
unresponsive antibiotic therapy, lobectomy might be an option |
(322−324) |
| liver |
hepatitis |
high
fever, relative bradycardia,
and left shift of WBCs |
|
liver damage markers
like
elevated serum alanine and aspartate transaminase levels, alkaline
phosphatase levels, and γ-glutamyl transferase levels. abdominal
ultrasonography (USG) or MR cholangiography. blood culture and serological
tests for Salmonella
|
|
(325) |
| spleen |
|
fever, chills, tenderness
in the left upper quadrant, and splenomegaly |
hemoglobinopathies, impaired
host resistance, subacute bacterial endocarditis, IV drug abuse, trauma,
diabetes mellitus, skin sepsis, respiratory tract infections, immunodeficiency,
and urinary tract infections |
ultrasonography (USG), USG-guided
aspiration followed by culturing the pathogen, Widal test, stool culture,
and blood culture |
drainage of the largest
abscesses along with antibiotic regimen is the favorable treatment.
percutaneous drainage preferred. Patients with multiple abscesses
unresponsive to percutaneous drainage might call for a splenectomy |
(326, 327) |
| urinary tract |
abscesses in kidney and
nephrons. rare complications are IgA nephropathy, hemolytic-uremic
syndrome, acute tubular necrosis, and Henoch-Schpnlein purpura |
structural or functional
abnormalities, pyelonephritis, dermoid cyst, calculi, dermoid cyst,
and renal transplant |
|
diagnosis is possible
by
culturing the pus from the abscesses |
needs the proper antimicrobial
regime. in the case of a perinephric abscess, a drainage procedure
might also be required in addition to the administration of antibiotics |
(328) |
| genital
tract |
pelvic inflammatory
diseases
(PID). along with the pelvis, Salmonella can form
abscesses in pelvic bones and intraperitoneal spaces |
fever, lower abdominal pain,
and leukocytosis |
most
of the cases had underlying
structural deformities like ovarian or dermoid cysts or were immunocompromised |
increase in WBCs, ultrasonography.
laparoscopic evaluation of the pelvic organs is the ideal method for
diagnosing tubo-ovarian abscesses. isolation of Salmonella Typhi from purulent abscesses may make definitive diagnosis possible |
7–14 days of antibiotic treatment in the case of genitourinary infections
or longer if underlying complications as stone or abscess collection
are seen |
(329, 330) |
| musculoskeletal system |
(i) osteomyelitis and (ii)
septic arthirits |
(i)
Ttypically, an infection
of the long bones like femur and humerus, it might also affect the
lumbar vertebrae, tibia, radius, and ulna. (ii) the chondrosternal
junctions, the hip, the sacroiliac joints, the spine, and the knee |
(i) predilection for patients
with systemic lupus erythematosus (SLE), diabetes mellitus, lymphoma,
liver and cardiovascular diseases, previous surgery or trauma, and
patients on steroids. (ii) immunosuppressed individuals or children
with congenital diseases where bacteremia has the propensity to spread
via hematogenous route to larger joints |
Salmonella osteomyelitis can be
confirmed by simultaneous isolation of Salmonella spp. from blood and pus of affected musculoskeletal
site, MRI, CT, and radiographs |
antimicrobial therapy and
surgical debridement |
(331) |
| skin |
Rose spots |
red, blanchable macular
lesions 2–4 mm in diameter,
which show up in 50% of the cases of enteric fever. within the seventh
to twelfth day from the onset of symptoms, rose-spots are seen to
occur in crops of 5–10 lesions
on the lower chest and upper abdomen and may last for 3–4 days |
|
Salmonella can be cultured from the puncture biopsies |
cured with antibiotics alone
without surgical intervention |
(15) |
