Isolation of salmonella typhi from pleural empyema necessitans- A case report from a tertiary care hospital, Bangalore, Karnataka

Pleural Empyema necessitans refers to the extension of an empyema out of the pleural space and in to the neighbouring chest wall and surrounding soft tissues.Salmonella typhi is a versatile pathogen with amazing potential of infecting almost all organs of its host. Globally, the life threatening illness caused by Salmonella typhi have made this pathogen a serious health concern for infection control professionals. 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. Various microbes have been found associated with pleural cavity abscesses that ultimately lead to high morbidity and mortality rates, but pulmonary involvement due to Salmonella infection is rare. We are reporting an unusaual and rare case of pleural cavity abscess caused by Salmonella typhi in a 44 years old febrile patient, admitted to a tertiary care hospital, Bangalore with a complaints of swelling on the left sided chest wall. Diagnosis was made by HRCT THORAX which revealed an well defined hypodense collection with peripheral rim enhancement in anterior chest wall around 7th to 8th costochondral junction, communication with left pleural cavity. Pus was collected from the abscess by incision and drainage. Salmonella enterica serotype typhi was isolated from the sample. Patient was put on appropriate antimicrobial therapy.