Non-typhoidal salmonella (NTS) can cause infections ranging from self-limited chronic carriers to gastroenteritis, bacteremia, and extraintestinal infections. Pulmonary involvement, particularly empyema, is quite rare and generally found in immunosuppressed individuals. We present a case of salmonellosis in an immunocompetent patient with rare pulmonary complications of empyema. The patient, with no underlying immunocompromised illness, presented with a one-day history of worsening generalized weakness, fever, shortness of breath, and productive cough after having gastroenteritis symptoms of five days duration, which stopped two days prior to admission. On further investigation, imaging revealed right lower lobe pneumonia with empyema. The patient was managed with intravenous antibiotics and chest tube placement with good clinical response. Pleural fluid analysis showed exudative fluid and grew Salmonella enteritidis with negative blood and sputum cultures. The patient, in stable condition, was discharged on four weeks of amoxicillin/clavulanic acid after consulting the infectious disease specialist for presumed aspiration pneumonia complicated with empyema in the setting of multiple episodes of vomiting due to gastroenteritis. The lung is an atypical site for salmonellosis. Pulmonary infections in immunocompetent hosts are rare in the medical literature. Early recognition and timely management of pulmonary complications can lead to better outcomes.
Keywords: aspiration; gastroenteritis; gastrointestinal; pneumonia; pulmonary empyema.
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