THORACIC EMPYEMA AS EXTRAINTESTINAL MANIF ESTATION OF SALMONELLA-ENTERITIDIS DURING IMMUNOSUPPRESSIVE THERAPY FOR AUTOIMMUNE HEPATITIS

An overlap syndrome PBC and AIH was diagnosed in a 54 year old woman. Initial treatment was composed of steroids, bile acids and azathioprin e. After bleeding from oesophageal vances in Juli 1994, pleural effusi on was diagnosed. Diagnostic pleurocentesis showed a transudate. Becau se of diarrhoea colonoscopy was performed which showed red spots throu ghout the whole colon. Histology did not how any relevant results. In September 1994, the patient presented with dry cough and dysponea. Ple urocentesis showed purulent exsudate with Salmonella enteritidis and S taphylococcus epidermidis positive microbiological analysis. The patie nt was treated with suction drainage, systemic antibiosis and systemic administration of steroids. By October 1994 patient was symptom-free. Both salmonella serology and stool analysis for these bacteria remain ed negative for the whole duration of her stay. This case demonstrates the positive influence of systemic administration of antibiotics in c ombination with local mechanical treatment (suction drainage) on pleur al salmonellosis.