Acute abdomen caused by Salmonella typhimurium infection in children

Salmonella spp. infections can be particularly challenging when they manife st as acute abdominal problems and lead to emergency surgery. Examples of s uch serious conditions are Salmonella-related intestinal perforation, gallb ladder involvement, salpingitis, and peritonitis. Mesenteric lymphadenitis associated with Salmonella typhimurium mimics acute appendicitis and can ma ke it difficult to establish a timely and definitive diagnosis in young pat ients who present with right lower abdominal pain. Paralytic ileus is a fai rly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Becaus e of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with acute abdomen and undergo needless operations. This report describes the cases of 2 pediatric patients who und erwent surgery to address persistent pain in the right lower abdominal quad rant and complete intestinal obstruction, respectively. The first patient h ad inflamed mesenteric lymph nodes that caused appendicitis like symptoms, and the second had dense adhesions between the mesentery and the terminal s egments of the ileum that led to intestinal blockage. Serology results show ed that both patients' titers for ED ("B and O agglutinating [BO]") antibod ies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. Copyright (C) 2001 by WB. Saunders Company.