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

TL;DR

A rare case of lung infection caused by Salmonella from a pet snake in an immunocompromised patient is reported.

Contribution

This is a novel case report of pulmonary infection by Salmonella enterica subsp. arizonae in an immunocompromised individual.

Findings

Salmonella enterica subsp. arizonae was identified in sputum cultures from a patient with a pet snake.

The infection was successfully treated with ciprofloxacin in a 2-week course.

The case emphasizes the need for awareness of this pathogen in immunocompromised patients with reptile exposure.

Abstract

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.