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Işık MC, Karcıoğlu O, Hazırolan G, Gülmez D, Onur MR, Kunt MM, Arikan-Akdagli S, Metan G. Necrotizing pneumonia due to Aspergillus and Salmonella after immune checkpoint inhibitor treatment: An unusual case and review of the literature. Rev Iberoam Micol 2023; 40:26-30. [PMID: 37714729 DOI: 10.1016/j.riam.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/18/2023] [Accepted: 05/24/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are a promising new treatment for different types of cancer. The infectious complications in patients taking ICIs are rare. CASE REPORT A 58-year-old male who received chemotherapy consisting of pembrolizumab (PD-1 inhibitor) for esophagus squamous cell carcinoma one month before was admitted to the emergency room with shortness of breath soon after fiberoptic bronchoscopy, which was done for the inspection of the lower airway. A computed tomography of the chest revealed a progressive consolidation on the right upper lobe. Salmonella group D was isolated from the bronchoalveolar lavage (BAL) fluid culture. The fungal culture of the same clinical sample yielded Aspergillus niger; furthermore, a high titer (above the cut-off values) of Aspergillus antigen was found both in the BAL fluid and serum of the patient. Despite the effective spectrum and appropriate dose of antimicrobial treatment, the patient died due to disseminated intravascular coagulopathy. CONCLUSIONS Awareness of unusual pathogens in the etiology of pneumonia after ICI treatment may help to avoid underdiagnosis.
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Affiliation(s)
- Muhammed Cihan Işık
- Department of Clinical Microbiology and Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Oğuz Karcıoğlu
- Department of Chest Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gülşen Hazırolan
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Dolunay Gülmez
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Ruhi Onur
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Mahir Kunt
- Department of Emergency, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sevtap Arikan-Akdagli
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gökhan Metan
- Department of Clinical Microbiology and Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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2
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Jiang X, Wang C, Guo J, Hou J, Guo X, Zhang H, Tan J, Li M, Li X, Zhu H. Global Meta-analysis of Airborne Bacterial Communities and Associations with Anthropogenic Activities. Environ Sci Technol 2022; 56:9891-9902. [PMID: 35785964 PMCID: PMC9301914 DOI: 10.1021/acs.est.1c07923] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Airborne microbiome alterations, an emerging global health concern, have been linked to anthropogenic activities in numerous studies. However, these studies have not reached a consensus. To reveal general trends, we conducted a meta-analysis using 3226 air samples from 42 studies, including 29 samples of our own. We found that samples in anthropogenic activity-related categories showed increased microbial diversity, increased relative abundance of pathogens, increased co-occurrence network complexity, and decreased positive edge proportions in the network compared with the natural environment category. Most of the above conclusions were confirmed using the samples we collected in a particular period with restricted anthropogenic activities. Additionally, unlike most previous studies, we used 15 human-production process factors to quantitatively describe anthropogenic activities. We found that microbial richness was positively correlated with fine particulate matter concentration, NH3 emissions, and agricultural land proportion and negatively correlated with the gross domestic product per capita. Airborne pathogens showed preferences for different factors, indicating potential health implications. SourceTracker analysis showed that the human body surface was a more likely source of airborne pathogens than other environments. Our results advance the understanding of relationships between anthropogenic activities and airborne bacteria and highlight the role of airborne pathogens in public health.
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Affiliation(s)
- Xiaoqing Jiang
- State
Key Laboratory for Turbulence and Complex Systems, Department of Biomedical
Engineering, College of Future Technology, Peking University, Beijing 100871, China
- Center
for Quantitative Biology, Peking University, Beijing 100871, China
| | - Chunhui Wang
- School
of Life Sciences, Peking University, Beijing 100871, China
| | - Jinyuan Guo
- State
Key Laboratory for Turbulence and Complex Systems, Department of Biomedical
Engineering, College of Future Technology, Peking University, Beijing 100871, China
- Center
for Quantitative Biology, Peking University, Beijing 100871, China
- Department
of Biomedical Engineering, Georgia Institute
of Technology and Emory University, Atlanta, Georgia 30332, United States
| | - Jiaheng Hou
- State
Key Laboratory for Turbulence and Complex Systems, Department of Biomedical
Engineering, College of Future Technology, Peking University, Beijing 100871, China
- Center
for Quantitative Biology, Peking University, Beijing 100871, China
| | - Xiao Guo
- State
Key Laboratory for Turbulence and Complex Systems, Department of Biomedical
Engineering, College of Future Technology, Peking University, Beijing 100871, China
- Center
for Quantitative Biology, Peking University, Beijing 100871, China
| | - Haoyu Zhang
- State
Key Laboratory for Turbulence and Complex Systems, Department of Biomedical
Engineering, College of Future Technology, Peking University, Beijing 100871, China
- Center
for Quantitative Biology, Peking University, Beijing 100871, China
| | - Jie Tan
- State
Key Laboratory for Turbulence and Complex Systems, Department of Biomedical
Engineering, College of Future Technology, Peking University, Beijing 100871, China
- Center
for Quantitative Biology, Peking University, Beijing 100871, China
| | - Mo Li
- School
of Life Sciences, Peking University, Beijing 100871, China
| | - Xin Li
- School
of Life Sciences, Peking University, Beijing 100871, China
- Beijing
National Day School, Beijing 100039, China
| | - Huaiqiu Zhu
- State
Key Laboratory for Turbulence and Complex Systems, Department of Biomedical
Engineering, College of Future Technology, Peking University, Beijing 100871, China
- Center
for Quantitative Biology, Peking University, Beijing 100871, China
- Department
of Biomedical Engineering, Georgia Institute
of Technology and Emory University, Atlanta, Georgia 30332, United States
- . Phone: 8610-6276-7261
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3
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Ong CC, Teo LL. Endemic Thoracic Infections in Southeast Asia. Radiol Clin North Am 2022; 60:445-459. [DOI: 10.1016/j.rcl.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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4
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Vázquez X, Forcelledo L, Balboa-Palomino S, Fernández J, Rodicio MR. Nosocomial Pneumonia Caused in an Immunocompetent Patient by the Emergent Monophasic ST34 Variant of Salmonella enterica Serovar Typhimurium: Treatment-Associated Selection of Fluoroquinolone and Piperacillin/Tazobactam Resistance. Antibiotics (Basel) 2022; 11:antibiotics11030303. [PMID: 35326766 PMCID: PMC8944838 DOI: 10.3390/antibiotics11030303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
The present report describes an uncommon case of nosocomial pneumonia caused by Salmonellaenterica in an immunocompetent patient. The patient was admitted to ICU of a tertiary hospital due to low level of consciousness, aphasia and seizure episodes. Four days after hospitalization, he developed nosocomial pneumonia, which evolved into septic shock. Gram-negative bacilli were recovered from blood, tracheal aspirate and fecal samples of the patient. The isolates, which were identified as Salmonella enterica, proved to be resistant to ciprofloxacin, amoxicillin/clavulanic acid and piperacillin/tazobactam. Four months before, the same bacterial species was recovered from feces and blood cultures of the patient, admitted to the nephrology ward of the same hospital with diagnosis of gastroenteritis and acute renal failure. However, at that time, the isolates were susceptible to the above-mentioned antibiotics. Genome sequencing revealed that all isolates were closely related and belonged to the emergent ST34 monophasic variant of S. enterica serovar Typhimurium. Since the patient has received therapy with fluoroquinolones and amoxicillin/clavulanic acid, these results support treatment-associated selection of the acquired resistances. In conclusion, this case represents a paradigm of selective pressure leading to in vivo development of resistance to highly relevant antibiotics, including the piperacillin/tazobactam combination used for empirical management of severe infections at ICU.
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Affiliation(s)
- Xenia Vázquez
- Área de Microbiología, Departamento de Biología Funcional, Universidad de Oviedo (UO), 33006 Oviedo, Spain;
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (L.F.); (J.F.)
| | - Lorena Forcelledo
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (L.F.); (J.F.)
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain;
| | - Salvador Balboa-Palomino
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain;
| | - Javier Fernández
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (L.F.); (J.F.)
- Servicio de Microbiología, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
- Research & Innovation, Artificial Intelligence and Statistical Department, Pragmatech AI Solutions, 33003 Oviedo, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, 28029 Madrid, Spain
| | - María Rosario Rodicio
- Área de Microbiología, Departamento de Biología Funcional, Universidad de Oviedo (UO), 33006 Oviedo, Spain;
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (L.F.); (J.F.)
- Correspondence: ; Tel.: +34-985103562
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Yogo A, Yamamoto S, Iwamoto N, Aoki K, Motobayashi H, Tochitani K, Shimizu T. Non-typhoidal Salmonella Bacteremia in COVID-19 with Recrudescence of Fever After Corticosteroid Discontinuation: A case report. IDCases 2022; 27:e01415. [PMID: 35096529 PMCID: PMC8779851 DOI: 10.1016/j.idcr.2022.e01415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 11/27/2022] Open
Abstract
Secondary bacterial infections occur in COVID-19 patients treated with corticosteroid. Rebound phenomenon is observed after the cessation of steroid treatment. Non-typhoidal Salmonella bacteremia is associated with immunosuppressive conditions. Blood cultures distinguish between secondary infections and rebound phenomena.
It is challenging for clinicians to determine the cause of occurrence of fever in COVID-19 patients after corticosteroid discontinuation. Blood cultures help us distinguish between secondary infections and rebound phenomena. We report a case of non-typhoidal Salmonella bacteremia in a 34-year-old male COVID-19 patient who developed fever after discontinuing corticosteroids.
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Sullivan A, Zachariah S, Agarwal P, Young D. An unusual case of non-typhi pleuropulmonary salmonellosis. Respir Med Case Rep 2022; 39:101739. [PMID: 36148407 PMCID: PMC9486106 DOI: 10.1016/j.rmcr.2022.101739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/19/2022] [Accepted: 09/12/2022] [Indexed: 10/31/2022] Open
Abstract
A middle-aged man with rheumatoid arthritis, without pulmonary involvement, on disease-modifying antirheumatic drugs (DMARD) presented with right sided pleuritic chest pain due to recurrent, right sided, loculated pleural effusion. Non-typhi Salmonella was isolated from pleural fluid sampling and the patient was successfully treated with open thoracotomy with decortication and six weeks of antibiotic therapy. Pulmonary salmonellosis is a rare infection typically found in immunocompromised patients that typically presents abruptly and requires prolonged antibiotic therapy.
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Rôlo Silvestre C, Nunes A, Cordeiro RJ, Eusébio J, André N, Falcão T, Domingos AC. Salmonella empyema an unusual infection - A case report. IDCases 2021; 24:e01096. [PMID: 33889492 DOI: 10.1016/j.idcr.2021.e01096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/28/2020] [Accepted: 03/25/2021] [Indexed: 11/20/2022] Open
Abstract
Pleuropulmonary Samonella infections are very rare and are associated with high mortality. We present a case of empyema to Salmonella in an 83-year-old male patient, with uncontrolled hematological disease. The patient presented with a one-week history of fever, productive cough with purulent sputum, dyspnea, and pleuritic pain localized to the right hemithorax. He denied having nausea, vomiting, and diarrhea. No history of smoking or respiratory diseases. Chest imaging showed a right loculated pleural effusion with adjacent parenchymal consolidation. Blood test revealed anemia without leukocytosis with elevated C-reactive protein (36.2 mg/dL). A chest tube was placed, with drainage of purulent fluid and empiric antibiotic therapy with ceftriaxone and clindamycin was started. Pleural fluid and blood cultures were positive for Salmonella serotype Enteritidis. The stool cultures were negative. Due to slow improvement, clindamycin was suspended and ciprofloxacin was initiated. The patient showed clinical and laboratory improvement. After seven weeks of antibiotic therapy, he presented with negative blood cultures and significant imaging improvement. The patient was discharged. This case describes a positive outcome in an unusual infection with a high mortality caused by non-typhoid Salmonella.
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Strutynskaya AD, Karnaushkina MA, Tyurin IE, Komarova IS. Salmonella sepsis in a patient with TLR4 gene polymorphisms. Radiol Case Rep 2020; 15:1545-1551. [PMID: 32670458 PMCID: PMC7341060 DOI: 10.1016/j.radcr.2020.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 11/27/2022] Open
Abstract
Non-typhoid Salmonella gastroenteritis is one of the most common forms of intestinal infections among the population of developed countries and generalized forms of infection are rare. We present a case of 67-year-old woman with salmonaella sepsis, deep venous thrombosis, and septic thromboembolism of pulmonary artery complicated with development of necrotizing pneumonia. Generalization of the infectious process was mediated by the presence of polymorphisms in the TLR4 gene. Development of pulmonary infarction is infrequent. Even rarer is a formation of cavities in infarcted lung tissue, usually in the background of the infectious disease. A combination of 2 rare conditions in 1 patient demonstrates the need of multidisciplinary approach in treatment of severe and atypical forms of infectious diseases to evaluate the primary etiology of such state. The article will discuss various aspects of lung tissue damage caused by Salmonella and give a brief overview of the literature on this topic.
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Affiliation(s)
- Anastasia D. Strutynskaya
- National Medical Research Center for Children's Health, Build.1, 2, Lomonosov Ave, Moscow, 119296, Russian Federation
- Corresponding author.
| | - Maria A. Karnaushkina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Igor E. Tyurin
- Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Irina S. Komarova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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Duhil de Bénazé G, Desselas E, Houdouin V, Mariani-Kurkdjian P, Kheniche A, Dauger S, Poncelet G, Gaschignard J, Levy M. Pneumonia with pleural empyema caused by Salmonella Typhi in an immunocompetent child living in a non-endemic country. Paediatr Int Child Health 2018; 38:227-230. [PMID: 28436267 DOI: 10.1080/20469047.2017.1316938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Extra-intestinal complications of Salmonella Typhi (S. Typhi) infections usually occur in endemic countries and in patients with underlying risk conditions. A 14-year-old immunocompetent girl was admitted with respiratory distress owing to S. Typhi pneumonia and pleural empyema. She was a native of Ivory Coast but had lived in France for 4 years and had not travelled abroad for several years. There were no gastro-intestinal symptoms and no S. Typhi carriage was detected in her family. She recovered completely with ceftriaxone and ciprofloxacin and pleural drainage was not required. An atypical presentation of S. Typhi should be considered even in settings where there are no risk factors.
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Affiliation(s)
- Gwénaëlle Duhil de Bénazé
- a Paediatric Intensive Care Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Emilie Desselas
- b Paediatric Infectious Disease Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Véronique Houdouin
- c Pneumology Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Patricia Mariani-Kurkdjian
- d Microbiology Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Ahmed Kheniche
- e Radiology Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Stéphane Dauger
- a Paediatric Intensive Care Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Géraldine Poncelet
- a Paediatric Intensive Care Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Jean Gaschignard
- b Paediatric Infectious Disease Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | - Michaël Levy
- a Paediatric Intensive Care Unit , Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
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Abstract
Salmonella spp. are food-borne pathogens that usually cause gastroenteritis, although bacteremia and subsequent focal metastatic infection can also occasionally occur. Of the known Salmonella spp., Salmonella houtenae is a rare subspecies, comprising less than 1% of all Salmonella strains. We herein report the first case of S. houtenae-induced empyema complicated with chronic tuberculous empyema, which was successfully treated by antibacterial agents alone. We wish to highlight the importance of being aware that Salmonella spp. can cause empyema in cases suffering from chronic tuberculous empyema; moreover, despite the successful completion of treatment with antibacterial agents, periodical follow-up is mandatory in such cases.
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Affiliation(s)
- Yuichi Mukai
- Department of Respiratory Medicine, National Hospital Organization Shinshu Ueda Medical Center, Japan
| | - Toshihiko Agatsuma
- Department of Respiratory Medicine, National Hospital Organization Shinshu Ueda Medical Center, Japan
| | - Gen Ideura
- Department of Respiratory Medicine, National Hospital Organization Shinshu Ueda Medical Center, Japan
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Thompson Bastin ML, Neville NR, Parsons RE, Flannery AH, Tennant SJ, Johnson CA. An unusual case of Salmonella Enteritidis causing pneumonia, septic shock and multiple organ failure in an immunocompetent patient. IDCases 2016; 6:85-89. [PMID: 27818944 PMCID: PMC5094264 DOI: 10.1016/j.idcr.2016.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/11/2016] [Accepted: 10/14/2016] [Indexed: 11/16/2022] Open
Abstract
Salmonella species are facultative intracellular pathogens that most frequently cause self-limiting gastrointestinal disease, often acquired through the ingestion of contaminated food. We report the case of a 33-year-old otherwise healthy, not overtly immunosuppressed, man who was transferred to our facility with the chief complaint of respiratory failure and septic shock. Computed tomography of the chest revealed multifocal pneumonia in both lungs. A bronchial alveolar lavage was performed in the right middle lobe and cultures predominantly grew Salmonella enterica serovar Enteritidis. The patient received a prolonged course of antimicrobials, ultimately changing to oral levofloxacin. The etiology of the salmonella infection likely occurred through an aspiration event. Salmonella species are not a typical respiratory pathogen in immunocompetent hosts; however, clinicians should be aware of the possibility that salmonella species may be a pathogenic source of infection in the lungs; a prolonged course of antimicrobials may be warranted.
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Affiliation(s)
- M L Thompson Bastin
- University of Kentucky HealthCare, Department of Pharmacy Services, 800 Rose Street H110, Lexington, KY 40536, USA; University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, 800 Rose Street H110 Lexington, KY 40536, USA
| | - N R Neville
- University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, 800 Rose Street H110 Lexington, KY 40536, USA
| | - R E Parsons
- University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, 800 Rose Street H110 Lexington, KY 40536, USA
| | - A H Flannery
- University of Kentucky HealthCare, Department of Pharmacy Services, 800 Rose Street H110, Lexington, KY 40536, USA; University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, 800 Rose Street H110 Lexington, KY 40536, USA
| | - S J Tennant
- University of Kentucky HealthCare, Department of Pharmacy Services, 800 Rose Street H110, Lexington, KY 40536, USA
| | - C A Johnson
- University of Kentucky College of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, 800 Rose Street H110 Lexington, KY 40536, USA
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