# Atypical Multidrug-Resistant Salmonella paratyphi B Infection in a Patient with Uncontrolled Diabetes Mellitus: A Case Report

**Authors:** Nandhini Ravella Venkatasubramanyam, Lavanya Ramanan, Neelusree Prabhakaran, Manivannan Nandhagopal

PMC · DOI: 10.7759/cureus.66000 · Cureus · 2024-08-02

## TL;DR

A diabetic patient had a rare Salmonella infection in a wound, which was successfully treated with proper antibiotics.

## Contribution

Reports a rare case of atypical Salmonella paratyphi B wound infection in a diabetic patient.

## Key findings

- Salmonella paratyphi B was isolated from a wound swab in a patient with uncontrolled diabetes.
- The isolate showed resistance to multiple antibiotics but was susceptible to chloramphenicol and cotrimoxazole.
- The patient's condition improved with appropriate wound care and targeted antibiotic treatment.

## Abstract

Atypical Salmonella infection usually presents with unusual symptoms in addition to gastroenteritis. Such atypical presentations can pose a challenge for diagnosis and treatment as they may be misdiagnosed, leading to delayed care and potential complications. Here we report an unusual case of Salmonella spp. isolated from a wound swab. A 57-year-old male patient with a history of uncontrolled type 2 diabetes presented to the general surgery department with a 25-day history of swelling, ulceration, and purulent discharge on his right foot. A wound swab was collected for culture and sensitivity. Gram staining showed occasional pus cells and a few gram-negative bacilli. Culture was done, and the organism was identified as Salmonella Paratyphi B with the help of other biochemicals. The isolate showed susceptibility to chloramphenicol and cotrimoxazole and resistance to other panels of antibiotics. Routine blood and urine analysis of the patient showed normal findings. Wound dressing was done on an alternative day, followed by administration of antibiotics. The patient was advised to follow up after two weeks. The clinical outcome in the above patient was satisfactory with appropriate antibiotics. We present a case of atypical typhoidal Salmonella as a rare cause of wound infection and not a major threat if diagnosed and treated accordingly.

## Linked entities

- **Chemicals:** chloramphenicol (PubChem CID 5959), cotrimoxazole (PubChem CID 358641)
- **Diseases:** type 2 diabetes (MONDO:0005148), Salmonella infection (MONDO:0000827)

## Full-text entities

- **Diseases:** purulent (MESH:D003234), ulceration (MESH:D014456), type 2 diabetes (MESH:D003924), Salmonella infection (MESH:D012480), wound infection (MESH:D014946), Diabetes Mellitus (MESH:D003920), gastroenteritis (MESH:D005759), swelling (MESH:D004487)
- **Chemicals:** chloramphenicol (MESH:D002701), cotrimoxazole (MESH:D015662)
- **Species:** Salmonella enterica subsp. enterica serovar Paratyphi B (no rank) [taxon 57045], Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC11366212/full.md

## References

17 references — full list in the complete paper: https://tomesphere.com/paper/PMC11366212/full.md

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Source: https://tomesphere.com/paper/PMC11366212