Case Report
 

By Dr. K.l Shobha , Dr. Annet D?souza , Dr. M Mridula , Dr. S R Gowrish
Corresponding Author Dr. K.l Shobha
Department of Microbiology,Melaka Manipal Medical College,Manipal Campus,Manipal university,Manipal, - India
Submitting Author Dr. Mahdi Esmaeilzadeh
Other Authors Dr. Annet D?souza
Kasturba Medical College ,Manipal, - India

Dr. M Mridula
Kasturba Medical College ,Manipal, - India

Dr. S R Gowrish
Melaka Manipal Medical College ,Manipal Campus,Manipal, - India

MEDICAL EDUCATION

Urinary tract Infection, Salmonella Typhimurium, HIV Seropositive Adult Male

Shobha K, D?souza A, Mridula M, Gowrish SR. Urinary Tract Infection Due to Salmonella Typhimurium in a HIV Seropositive Adult Male: A Case Report. WebmedCentral MEDICAL EDUCATION 2012;3(1):WMC002930
doi: 10.9754/journal.wmc.2012.002930

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
No
Submitted on: 26 Jan 2012 05:51:32 AM GMT
Published on: 27 Jan 2012 08:00:46 PM GMT

Introduction


Despite advances in the prophylaxis and treatment, infection due to non typhoidal Salmonella is seen. The isolation of non typhoidal salmonella from urine specimen is unusual and is commonly related to immunocompromised patients. Here we present a case of HIV infected patient with urinary tract infection.

Case Report


A 51 year old male, smoker and alcoholic for the past 20 years presented to medicine OPD with history of urgency, frequency, dysuria and pain in the hypogastric region. He was diagnosed as HIV seropositive five years back and was also treated for disseminated tuberculosis, strongyloidoisis and oral candidiasis. On examination his posterior cervical lymph nodes, axillary and inguinal lymph nodes bilateral were enlarged. Liver was also palpable. Ultrasound abdomen showed grade-1 renal parenchymal changes. Urine was sent to laboratory for investigations. Urine protein was 2+ (100mg/dl), sugar was negative, WBC 12-15 /HPF, RBC 1-2/HPF, Epithelial cells 1-2 /HPF. Casts and cysts were negative, bacteria were present. Urine on Gram’s stain showed gram negative bacilli and pus cells. Urine was plated onto culture media i.e Blood agar and MacConkey’s agar for estimation by semiquantitative technique and to follow Kass’s concept of significant bacteriuria. Growth showed ≥100000 CFU/ml on blood agar and nonlactose fermenting colonies on MacConkey’s agar. Further identification was done as described by Baird-Parker. Strains were serotyped as per the scheme of Kauffmann. Strain was sent to central research institute, Kasauli and was identified as Salmonella typhimurium. Strain was sensitive to ciprofloxacin, amoxicillin, cefotaxime, chloramphenicol and co-trimoxazole. Patient was treated with ciprofloxacin and repeat  urine sample did not yield any growth.
Study conducted by Lee SC et al [1], analysed Salmonella bacteremia and found S typhimurium in 30/83 episodes and S enteritidis18/40 episodes. Most of the strains were from the immunocompromised patients (75%),
A retrospective survey conducted by the Centers for Disease Control (CDC) in 1982 identified 3,393 urine isolates of Salmonella submitted to their laboratories over a period recovered from infants younger than 1 year of age to persons 60 years of age or older. 17 serotypes of Salmonella accounted for 75% of urine isolates and the risk factors include immunocompromised conditions [2,3]
Further clarification of the role of non typhoidal Salmonella in AIDS patients with UTI seems warranted.

References


1. Lee SC, Yang PH, Shieh WB, Lasserre R ,Bacteremia due to non-typhi Salmonella : analysis of 64 cases and review: Clin Infect Dis 1994:19:693-6
2. Embil JM,Nicolle LE,Salmonella urinary tract infections associated with exposure to pet iguanas. Clin Infect Dis .1997:25:172 (PubMed )
3. Ramos M,Aguado JM,Garcia P,Ales JM,Soriano F,Clinical spectrum of urinary tract infections due to nontyphoidal Salmonella species. Clin Infect Dis :1996:23:388-390(Pub Med)

Source(s) of Funding


none

Competing Interests


none

Disclaimer


This article has been downloaded from WebmedCentral. With our unique author driven post publication peer review, contents posted on this web portal do not undergo any prepublication peer or editorial review. It is completely the responsibility of the authors to ensure not only scientific and ethical standards of the manuscript but also its grammatical accuracy. Authors must ensure that they obtain all the necessary permissions before submitting any information that requires obtaining a consent or approval from a third party. Authors should also ensure not to submit any information which they do not have the copyright of or of which they have transferred the copyrights to a third party.
Contents on WebmedCentral are purely for biomedical researchers and scientists. They are not meant to cater to the needs of an individual patient. The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. Your use of the WebmedCentral site and its contents is entirely at your own risk. We do not take any responsibility for any harm that you may suffer or inflict on a third person by following the contents of this website.

Comments
0 comments posted so far

Please use this functionality to flag objectionable, inappropriate, inaccurate, and offensive content to WebmedCentral Team and the authors.

 

Author Comments
0 comments posted so far

 

What is article Popularity?

Article popularity is calculated by considering the scores: age of the article
Popularity = (P - 1) / (T + 2)^1.5
Where
P : points is the sum of individual scores, which includes article Views, Downloads, Reviews, Comments and their weightage

Scores   Weightage
Views Points X 1
Download Points X 2
Comment Points X 5
Review Points X 10
Points= sum(Views Points + Download Points + Comment Points + Review Points)
T : time since submission in hours.
P is subtracted by 1 to negate submitter's vote.
Age factor is (time since submission in hours plus two) to the power of 1.5.factor.

How Article Quality Works?

For each article Authors/Readers, Reviewers and WMC Editors can review/rate the articles. These ratings are used to determine Feedback Scores.

In most cases, article receive ratings in the range of 0 to 10. We calculate average of all the ratings and consider it as article quality.

Quality=Average(Authors/Readers Ratings + Reviewers Ratings + WMC Editor Ratings)