Case Report of Invasive Salmonella Superinfection of an Ovarian Endometrioma in a Patient With Systemic Lupus Erythematosus.

OBJECTIVE

To present a case of invasive salmonella superinfection of an ovarian endometrioma in a patient with systemic lupus erythematosus, most likely due to exacerbation of a prior infection due to immunocompromised status, and review of literature on the typical and atypical manifestation of salmonella infection.

DESIGN

Case report and mini-review. We used the CARE checklist when writing our report.

MATERIALS AND

METHODS

For diagnosis of Salmonella bacteremia, cultures were used. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) was used to further diagnose the patient with Salmonella enterica ssp. diarizonae.

SETTING

University-based OBGYN service.

PATIENT: A 40-year-old G3P3003 female, initially presenting with nausea, non-bloody emesis, watery diarrhea, subjective fevers, and extreme fatigue, was found to have positive cultures for salmonella infection. Cefepime was administered with subsequent marked improvement in symptoms. Patient represented 2 months later with abdominal pain and fever and was confirmed to have a salmonella-infected endometrioma.

INTERVENTION: Explorative laparotomy, right salpingo-oophorectomy, and left adnexal cyst drainage.

MAIN OUTCOME: Outcome and complication of surgical management of salmonella superinfection of an ovarian endometrioma.

RESULT: Post-op, the patient experienced post-op fevers until POD7, when her symptoms began to improve significantly. Persistent fevers were attributed to surgical complications involving a cyst rupture during removal. The patient was subsequently discharged with a 6-week course of Ciprofloxacin 500 mg BID and suppressive amoxicillin PO 500 mg BID after completing the Ciprofloxacin regimen due to immunocompromised status.

CONCLUSION

Assessment for metastasis to other organs is crucial in evaluating immunocompromised patients diagnosed with salmonella infections. Surgical management should be highly considered.