CLINICAL SPECTRUM OF FOCAL INFECTION BY S ALMONELLA-NO-TYPHI - 32-YEARS EXPERIENCE

BACKGROUND: The aim of this study was to analyze the manifestations of the syndromes which constitute focal infection by Salmonella no typhi (SNT). METHODS: Ninety-one episodes of SNT infections studied over a period of 32 years in the Fundacion Jimenez Diaz (Madrid, Spain) were retrospectively analyzed. RESULTS: Of the 1,892 patients with SNT infe ction studied during this period, 91 (5%) presented some focal form (5 7 males and 34 females) with a mean age of 49 years (SD +/- 21.6 years ). Sixty percent of the episodes were acquired within the community. T he localization of the focal infections by SNT was as follows: urologi c tract (24%), intraabdominal (20%), soft tissues (16%), respiratory t ract (15%), osteoarticular (14%), cardiovascular (10%) and central ner vous system (1%). On comparison with the remaining patients, those wit h urinary, osteoarticular and respiratory infections were found to be the most frequently immunosuppressed (47% vs 18%, p < 0.01) with a gre ater frequency of unfavorable evolution (57% vs 15%; p < 0.001). Morta lity ranged between 7% for the osteoarticular forms to 64% for the ple uropulmonary forms of infection. CONCLUSIONS: Focal infection by Salmo nella no typhi may be localized in any organ usually occuring in immun osuppressed patients or those with predisposing local factors. The ost eoarticular, pulmonary, and urologic infections have a particularly un favorable course and their presence may suggest the existence of immun osuppression.