Salmonella typhimurium-endocarditis secondary to an acquired environmentalinfection: A case report

A diabetic, cardiopathic and anemic 44-year-old farmer presented with a sev en-day history of remittent fever with evening peaks. Two months before he had undergone amputation of the V-finger of the left hand secondary to a ph legmon caused by an agricultural injury. Prior to amputation, anaerobic cul ture analysis of phlegmon-pus and selective procedures used to isolate Gram -positive cocci and/or Pseudomonas spp. resulted negative. The diagnosis of endocarditis was supported by isolation of S. typhimurium from blood and b y echocardiography showing endocarditic lesions. The source of infection wa s identified by PCR ribo-typing as the same Salmonella typhimurium strain t hat was present, but not sought, both in the anatomic explanted tissues and from blood samples of the patient. The infection was successfully treated with a combination of gentamicin and ampicillin with consequent improvement in the general clinical picture of the patient. We believe this is the fir st reported case of S. typhimurium-endocarditis secondary to a phlegmon res ulting from an environmental source of infection.