A cold-blooded culprit: Salmonella enterica subsp. arizonae pulmonary infection in an immunocompromised patient: a case report.

Background. Salmonella enterica subsp. arizonae is an uncommon zoonotic pathogen primarily associated with reptiles. While most infections are gastrointestinal, invasive infections such as bacteraemia, osteomyelitis, meningitis and septic arthritis have been reported, particularly in immunocompromised individuals. Pulmonary infections are exceedingly rare. Case presentation. A 66-year-old woman with rheumatoid arthritis on a tumour necrosis factor-alpha inhibitor presented with a 2 week history of progressive cough and dyspnoea. She reported prolonged exposure to a pet snake. Sputum cultures confirmed S. enterica subsp. arizonae, with susceptibility to ciprofloxacin. Imaging revealed the right lower lobe infiltrate without cavitation. She was successfully treated with ciprofloxacin for 2 weeks, with resolution of symptoms. Conclusion. This case highlights an uncommon presentation of Salmonella infection in an immunocompromised patient with bronchiectasis. With increasing exotic pet ownership, clinicians should maintain a high index of suspicion for Salmonella enterica subsp. arizonae in patients with known reptile exposure.