1. Pyelonephritis with bacteremia caused by Salmonella Choleraesuis in a Japanese patient with carcinoma of unknown primary origin: A case report.
- Author
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Itoh N, Akazawa N, Yamaguchi M, Ishibana Y, Murakami H, Ohkusu K, Ohkusu M, and Ishiwada N
- Subjects
- Humans, Male, Neoplasms, Unknown Primary microbiology, Neoplasms, Unknown Primary complications, Japan, Salmonella isolation & purification, Salmonella genetics, Salmonella enterica isolation & purification, Multilocus Sequence Typing, Aged, Piperacillin, Tazobactam Drug Combination therapeutic use, East Asian People, Pyelonephritis microbiology, Pyelonephritis diagnosis, Pyelonephritis drug therapy, Bacteremia microbiology, Bacteremia drug therapy, Bacteremia diagnosis, Salmonella Infections microbiology, Salmonella Infections diagnosis, Salmonella Infections drug therapy, Anti-Bacterial Agents therapeutic use
- Abstract
Salmonella enterica subspecies enterica serovar Choleraesuis (S. Choleraesuis) is a nontyphoidal Salmonella pathogen that causes swine paratyphoids. S. Choleraesuis is a zoonotic pathogen transmitted to humans via contaminated food and causes sepsis. Here, we report a rare case of pyelonephritis caused by S. Choleraesuis in a Japanese patient with a carcinoma of unknown primary origin. On the day of admission, the patient was diagnosed with pyelonephritis associated with ureteral stent obstruction. He had no history of raw pork consumption or gastrointestinal symptoms. Gram-negative rods were isolated from urine and blood cultures, identified as Salmonella enterica subsp. enterica using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The serological typing results were O7: -: 1 and 5; however, the serotypes could not be determined. The isolate was identified as S. Choleraesuis using multilocus sequence typing, nucleotide sequence analysis of the fliC gene, and biochemical examination. Four days after a 14-day course of intravenous piperacillin-tazobactam (9 g/day), the patient showed relapse of the condition. Subsequently, the patient was treated with intravenous ceftriaxone (2 g/day) and oral amoxicillin (1000 mg/day) for 14 days each; recurrence was not observed. This novel case of pyelonephritis with bacteremia was caused by S. Choleraesuis in Japan. Conventional testing methods could not identify the serotypes; however, the case highlights the importance of adopting advanced diagnostic techniques based on molecular biology to ensure accurate pathogen identification., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2024
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