Salmonella epididymitis with recurrent septicemia in diabetic patient

Salmonella prostatitis in a man with spinal cord injury

CONTEXT

Prostatitis is a very unusual manifestation of Salmonella urinary tract infection and has not been reported in men with spinal cord injury (SCI).

FINDINGS

A 57-year-old man with paraplegia and a history of recurrent symptomatic urinary tract infections presented with Salmonella typhimurium prostatitis. Clinical and sonographic examination of the urinary tract, as well as urinalysis including microbiologic examination, revealed no relevant abnormalities. The microbiologic analysis of the ejaculate revealed growth of monophasic Salmonella enterica ssp. enterica serotype 4,12:i:-. A 6-week course of antibiotic treatment was initiated. There were no recurrent symptomatic urinary tract infections during follow-up.

CONCLUSION

Salmonellosis is a reportable disease and carriers have to refrain from activities in the food sector. Therefore, Salmonella prostatitis should be considered and excluded in men with SCI and a history of recurrent urinary tract infection who use intermittent catheterization for bladder management.

Epididymo-orchitis and testicular abscess caused by Salmonella enteritidis in immunocompromised patients in Kuwait

OBJECTIVE

To report relatively uncommon presentations of epididymo-orchitis and testicular abscess caused by Salmonella spp. in 2 immunocompromised patients.

CLINICAL PRESENTATION AND INTERVENTION

A 56-year-old man, a known case of systemic lupus erythematosus on azathioprine and prednisolone therapy, developed urinary tract infection followed by bacteremia and epididymo-orchitis. Both urine and blood cultures yielded Salmonella enteritidis strains, which were demonstrated by pulsed-field gel electrophoresis typing method to be genotypically identical. The second patient, a 55-year-old diabetic (type II), presented with a testicular abscess from which a pure culture of S. enteritidis was obtained. Both were treated with intravenous piperacillin and amikacin followed by oral ciprofloxacin, responded well to the therapeutic regimen and were discharged home well. Their follow-ups were uneventful.

CONCLUSION

This report shows that it is important to consider Salmonella infection in the differential diagnosis of inflamed and tender testis in immunocompromised patients and to include blood, urine and stool cultures in all cases.