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Salmonella Focal Infection — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsSalmonella Focal InfectionSCE Infectious Diseases

A 40-year-old man with no travel history presents with fever and a CT abdomen showing a splenic abscess. Blood cultures grow Salmonella enteritidis. He has no known immunodeficiency. What underlying condition should be investigated?

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Correct answer: C — Sickle cell disease or other haemoglobinopathy — Salmonella has a predilection for infarcted tissue including the spleen in sickle cell disease

Non-typhoidal Salmonella (NTS) causing focal infections (splenic abscess, osteomyelitis, mycotic aneurysm) should prompt investigation for underlying conditions: sickle cell disease (Salmonella has tropism for infarcted/ischaemic tissue), other haemoglobinopathies, HIV, immunodeficiency, and vascular abnormalities (infected aortic aneurysm). In sickle cell disease, Salmonella is the most common cause of osteomyelitis (more common than S. aureus — unique to SCD). Splenic abscess from NTS in a previously healthy patient is unusual and warrants investigation.

Reference: UKHSA 2023 – Salmonellosis; BSH 2022 – Sickle cell disease