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Malik A, Sharma M, Johnson LB, Bhargava A. Gallbladder Empyema and Epidural Abscess Due to Salmonella Enteritidis After Treatment of Primary Infection: Case Report and Review of the Literature. Open Forum Infect Dis 2023; 10:ofad432. [PMID: 37608918 PMCID: PMC10442058 DOI: 10.1093/ofid/ofad432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023] Open
Abstract
Nontyphoidal Salmonella can cause gallbladder empyema and disseminated disease in patients with suppressed immune systems. We are reporting a unique case of concomitant gallbladder empyema and epidural abscess due to Salmonella enterica subsp enterica serovar Enteritidis in a patient who was appropriately treated for the primary Salmonella infection complicated by bacteremia. A high degree of suspicion is needed in high-risk patients as timely intervention can avoid life-threatening complications.
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Affiliation(s)
- Ambreen Malik
- Division of Infectious Disease, Ascension St John Hospital, Grosse Pointe, Michigan, USA
| | - Mamta Sharma
- Division of Infectious Disease, Ascension St John Hospital, Grosse Pointe, Michigan, USA
- Division of Infectious Disease, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Leonard B Johnson
- Division of Infectious Disease, Ascension St John Hospital, Grosse Pointe, Michigan, USA
- Division of Infectious Disease, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ashish Bhargava
- Division of Infectious Disease, Ascension St John Hospital, Grosse Pointe, Michigan, USA
- Division of Infectious Disease, Wayne State University School of Medicine, Detroit, Michigan, USA
- Division of Infectious Disease, Thomas Mackey Center for Infectious Disease Research, Detroit, Michigan, USA
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Ghio M, Billiot A, Zagory JA, Brandt ML. Cholecystitis secondary to Salmonella typhi: a rare pathology with an unreported management option—a case report and literature review. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-022-00199-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This report describes the presentation and course of treatment for one of the youngest reported cases of empyema of the gallbladder. Given the rare occurrence of this disease process, we elected to proceed with a systematic review of the literature. This is only the 7th case series discussing pediatric empyema of the gallbladder due to Salmonella typhi in the literature, and the second case ever reported in the USA.
Case presentation
We report a case of a previously healthy 13-month-old girl who presented with diffuse peritonitis and equivocal imaging studies. Diagnostic laparoscopy revealed purulent peritonitis. The gallbladder was distended with intraluminal pus. Laparoscopy was converted to laparotomy to facilitate exposure, and a cholecystostomy tube was placed. Cultures from the fluid were positive for Salmonella typhi. The patient received a 14-day course of intravenous Ceftriaxone followed by 14 days of oral amoxicillin and clavulanate. A cholangiogram performed 8 weeks after surgery confirmed normal biliary anatomy. The cholecystostomy tube was removed. The patient recovered uneventfully and is doing well over 9 months later.
Conclusion
There is no consensus on treatment with options reported ranging from medical management with antibiotic therapy to more invasive procedures such as cholecystostomy tube or cholecystectomy. Less invasive management options are an alternative for Salmonella cholecystitis.
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Staels F, Collignon T, Betrains A, Gerbaux M, Willemsen M, Humblet-Baron S, Liston A, Vanderschueren S, Schrijvers R. Monogenic Adult-Onset Inborn Errors of Immunity. Front Immunol 2021; 12:753978. [PMID: 34867986 PMCID: PMC8635491 DOI: 10.3389/fimmu.2021.753978] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/22/2021] [Indexed: 12/28/2022] Open
Abstract
Inborn errors of immunity (IEI) are a heterogenous group of disorders driven by genetic defects that functionally impact the development and/or function of the innate and/or adaptive immune system. The majority of these disorders are thought to have polygenic background. However, the use of next-generation sequencing in patients with IEI has led to an increasing identification of monogenic causes, unravelling the exact pathophysiology of the disease and allowing the development of more targeted treatments. Monogenic IEI are not only seen in a pediatric population but also in adulthood, either due to the lack of awareness preventing childhood diagnosis or due to a delayed onset where (epi)genetic or environmental factors can play a role. In this review, we discuss the mechanisms accounting for adult-onset presentations and provide an overview of monogenic causes associated with adult-onset IEI.
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Affiliation(s)
- Frederik Staels
- Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunology, KU Leuven, Leuven, Belgium.,Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | | | - Albrecht Betrains
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Infectious and Inflammatory Disease, KU Leuven, Leuven, Belgium
| | - Margaux Gerbaux
- Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunology, KU Leuven, Leuven, Belgium.,Vlaams Instituut voor Biotechnologie - Katholieke Universiteit (VIB-KU) Leuven Center for Brain and Disease Research, Leuven, Belgium
| | - Mathijs Willemsen
- Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunology, KU Leuven, Leuven, Belgium.,Vlaams Instituut voor Biotechnologie - Katholieke Universiteit (VIB-KU) Leuven Center for Brain and Disease Research, Leuven, Belgium
| | - Stephanie Humblet-Baron
- Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunology, KU Leuven, Leuven, Belgium
| | - Adrian Liston
- Department of Microbiology, Immunology and Transplantation, Laboratory of Adaptive Immunology, KU Leuven, Leuven, Belgium.,Laboratory of Lymphocyte Signalling and Development, Babraham Institute, Cambridge, United Kingdom
| | - Steven Vanderschueren
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Infectious and Inflammatory Disease, KU Leuven, Leuven, Belgium
| | - Rik Schrijvers
- Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium.,Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
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Hematologically important mutations: X-linked chronic granulomatous disease (fourth update). Blood Cells Mol Dis 2021; 90:102587. [PMID: 34175765 DOI: 10.1016/j.bcmd.2021.102587] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/01/2023]
Abstract
Chronic granulomatous disease (CGD) is an immunodeficiency disorder affecting about 1 in 250,000 individuals. CGD patients suffer from severe bacterial and fungal infections. The disease is caused by a lack of superoxide production by the leukocyte enzyme NADPH oxidase. Superoxide and subsequently formed other reactive oxygen species (ROS) are instrumental in killing phagocytosed micro-organisms in neutrophils, eosinophils, monocytes and macrophages. The leukocyte NADPH oxidase is composed of five subunits, of which the enzymatic component is gp91phox, also called Nox2. This protein is encoded by the CYBB gene on the X chromosome. Mutations in this gene are found in about 70% of all CGD patients in Europe and in about 20% in countries with a high ratio of parental consanguinity. This article lists all mutations identified in CYBB and should therefore help in genetic counseling of X-CGD patients' families. Moreover, apparently benign polymorphisms in CYBB are also given, which should facilitate the recognition of disease-causing mutations. In addition, we also include some mutations in G6PD, the gene on the X chromosome that encodes glucose-6-phosphate dehydrogenase, because inactivity of this enzyme may lead to shortage of NADPH and thus to insufficient activity of NADPH oxidase. Severe G6PD deficiency can induce CGD-like symptoms.
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